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In her age group, abdominal pain, especially around the navel is common.
Sometimes thay are due to problems in the abdomen and gastrintestinal system, at other times they are NOT related to the abdomen at all.
The history of associated bed wetting should trigger the investigation of both her gastrointestinal tract and her urinary tract as well.
I believe at this point after physical examination, the Gp must have done not just her blood count but her other tests like her Liver function test. Also urinalysis and urine culture to rule out urinary tract abnormalities and infection.
She might benefit from an abdominal ultrasound as well, just to make sure thare are no hernias (pin hole umbilical, and epigastric). other things like mesenteric adenitis, and abnormalities of the colon.
If all these results are negative, it will be wise to seek some psychological evaluation, by a pediatric clinical psychologist.
A significant percentage of children in that age group with abdominal pain, without a determined cause, may be due to some issues which parents MOST times are NOT aware of
There is also something called abdominal migraine.
ultrasound will also evaluate for some MORE SERIOUS conditions like tumors and congenital abnormalities of the kidneys, liver or pancreas
I specifically mentioned she doesn't have any accidents at night but you have taken this to mean she wets the bed???
She had an ultrasound last year after three UTIs in one year. This came back as normal.
You haven't actually mentioned anything about my questions over diet and why the doctors say it is because she is constipated causing the encopresis when she eats better than most kids. Or why she could go six months with no problems and then it all starts again.
No You said inter alia 'occasionally she will go through a phase of wetting as well'
Now there are specific dietary causes of abdominal pain, and they usually have associated symptoms, rather than abdominal pain and frequent or uncontrollable bowel movements.
So please understand the medical logic, based on understanding of normal physiology(function) of the gastrointestinal tract.
The fact that she never 'have accidents in the night' means that whatever it is, has to do with her consciousness.
If she had other associated symptoms, like nausea, vomitting, fever, and diarrhea, thenone would consider specific pathologies.
In fact, medically the fact that she went six months without the 'accidents' means it is not a pathologically progressive illness or disorder.
The solution would be to continue giving her a balanced diet of vegetables, fruits and complex carbohydrates. Avoid refined carbohydrates like flour/bread.
If she is does not take milk (lactose intolerance can easily be tested), then find an alternative source of protein. Soy for example.
Medically, if ultrasounds are normal, then an endoscopy may need to be done, BUT remember this has to be at the discretion of her pediatricians. Another alternative is to ask to be reffered to a Pediatric gastroenterologist.
My advise (which I think is why you came to Justanswer.com) An honest advise, from a physician of 23 years and a pediatric emergency provider, IS
Begin consultation with a pediatric clinical psychologist, even as the medical tests are on-going, THERE ARE PROVEN methods of
Getting her to consciously control her bowel. these are done on individualized basis and theefore need extensive consultation and interviews.
YOU should also start her on a balanced multivitamin, in consult with your pediatrician. T
The crack in the mouth may be angular cheilitis and could be due to Vitamin B and other nuitritional deficiencies. It is also found in immune disorders which can easily be tested by your pediatrician
The above are the MAJOR, OR SERIOUS DISEASES that may affect children causing abdominal pain. Appendicitis is acute. So it s out, gall stones would have been picked by ultrasound, so would have tumors or cancer, intussusception (rare in her age). Hernias would have been obvious or picked up by ultrasound, Stomach ulcers, inflamatory bowel disorders have associated symptoms of vomitting, diarrhea, fever etc. urinary tract infections are covered already as you alluded. Sickle cell disease is familial and must have been checked (otherwise ask your doctor to do so)
So like i said, get additional consultation from a gastroenterologist, (may be endoscopy). then begin rehabilitating her. Diet must avoid milk and refined carbs. include multivitamins.
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