Teen: frequent waves of nausea, dizzy, bloated feeling

[chlobo]

When I was in my early 20s I had frequent bouts of nausea which caused me to lose weight. After a long arduous process where I had several more invasive tests, the 3rd GI I saw tested me for lactose intolerance. He didn't really think I had it because I had an atypical presentation but I indeed had it.

Sometimes people can develop temporary lactose intolerance due to stress or illness so its completely possible that your daughter could have something like that. I might also ask about an ulcer, since you mention she is under so much self-imposed pressure. Sounds like a recipe for that.

Hopefully her pediatrician will not just zero in on the anxiety. I have seen this trend a lot.

[DualvansMommy]

It could get well be anxiety as it really present differently in so many people.

Migraines was another thought too.

But if she started periods yet? Maybe it’s cycle related? I had a girlfriend who had a lot of same symptoms and lot of it came from her period. It would often stress her out so much that it presented as anxiety or stomach issues.


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[wendibird22]

She’s not taking any meds. Just ibuprofen, which we cut, and just this week kids alma seltzer chews.

She got her period at age 11.5 and we’ve talked about that as a possibility but it doesn’t seem to be cycle related because the frequency/pattern doesn’t seem to align.


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[dogmom]

First off you need to prepare yourself and her that these kind of symptoms have so many overlapping diagnoses that the differential is long, involved and different specialities will have different views. Additionally, because she is a young and a girl there is going to be a lot of downplaying. So I would encourage you to address this with you DC with the idea that you will work with her to help get her better, but it might not be a quick process. Other things to add:

Endometriosis if she is past menarche
Post viral syndromes
Abdominal migraines
Infectious processes-I had these symptoms for months before they finally escalated to constant vomiting. Turns out I had giardia, which is a parasite, that we found because I instead on a stool O&P. My kids had it also, but sub clinical. Cleared up with after the first two dose of Flagyl. The only reason they were testing my stool is they found out I was an ICU nurse and wanted to rule out C-Diff instead of just tell me it was GERD or IBS, which they were leaning towards. They of course ignored the fact I was, it’s not C-Diff, I know what that is better than you because I clean it up at least once a week, but hey, I’m sure you know more.

Also, if someone just wants to mark it down as simple anxiety I would be cautious. Not that it’s not possible, but it all depends on the approach. You can absolutely have physical manifestation of things we categorize as psychiatric problems, but that does not mean someone is faking or needs to get over it. Once you see someone in a vegetative state from psychiatric catatonia, which can be fatal, you stop thinking in hard lines between mental and physical health.

[California]

Thank you dogmom for writing that all out. I've been reflecting on this and want to emphasize that my mentee did first work with her pediatrician before getting a diagnosis. So my comment is only meant to be a "yes, anxiety is one of many possibilities" response. And oh my gosh, dogmom, my sweet teen's pain (my teen is going through something different- an extra bone in their foot) get downplayed all the time by doctors. What is up with that???

Nausea (and for my mentee sometimes diarrhea) can be a physical response to anxiety triggering the body's flight/fight/freeze response. It's a very real physical response caused by a hormonal/chemical change in the body that is intended to gear the body up to fight/flee. I don't want to minimize it at all. I don't want to go into too much info on my mentee, but it has been really hard on her.

[gamma]

With many girls, it can also be tied to menstruation. If they skip breakfast during this time or in a crowed, hot environment. Add in stressors and the nausea, headaches and dizziness will result.

[JElaineB]

Before you got to the part where you said you carry a Celiac gene I was thinking those sound a lot like my DH's symptoms and he was only diagnosed with Celiac last year at age 57, so it can happen at any time. I would have her tested for the Celiac genes as well as active Celiac, along with other possibilities. Actual diagnosis may require an endoscopy.

[dogmom]

Thank you dogmom for writing that all out. I've been reflecting on this and want to emphasize that my mentee did first work with her pediatrician before getting a diagnosis. So my comment is only meant to be a "yes, anxiety is one of many possibilities" response. And oh my gosh, dogmom, my sweet teen's pain (my teen is going through something different- an extra bone in their foot) get downplayed all the time by doctors. What is up with that???

Nausea (and for my mentee sometimes diarrhea) can be a physical response to anxiety triggering the body's flight/fight/freeze response. It's a very real physical response caused by a hormonal/chemical change in the body that is intended to gear the body up to fight/flee. I don't want to minimize it at all. I don't want to go into too much info on my mentee, but it has been really hard on her.

I think the downplaying of pain comes from three sources. Some is just blatant social misogyny and seeing kids as not fully human. Some is teens that haven’t had a lot of pain can absolutely rate their pain higher than an older adult, BUT, with the way hormones and the nervous system works one could argue they really feel pain more acutely. There is a reason your first love is so freaking intense, your brain is just absolutely awash in hormones, still developing and just a huge sponge for all the feelings. The last reason is we really don’t want to see kids suffer, so we would rather think it’s not as bad as they say. (Look at how much we downplay everything causing stress for kids now and just want to blame the phone.) It is easier for us to remember the time the teen said their pain was 10/10, after I tell the that’s you are disembowel and on fire 10, while they are texting on their phone. We don’t think of the quiet withdrawn kid who says they are in pain, but people downplay it and tell them they are being lazy and to go to school, so they just do. Because so much of their life is adults telling them their life experience is not real.

[hbridge]

Start tracking ... EVERYTHING for a few weeks/months

Periods, meds, diet, symptoms, hydration, activity level, bowel movements (and type)...

It sounds crazy, but this is how we figured out DC was allergic to NSAIDS. I tracked symptoms by date, severity, ect. However, when I added in their period, it coincided. DC took NSAIDS for cramps (on the advice of a developmental pediatrician). I didn't think they were related until I mapped everything out.

Just keep track, the data may help your doctors.

DO NOT let them dismiss it as anxiety without investigating further. My migraines were diagnosed as anxiety for 30 years before someone thought to test for celiac...

[hbridge]

We don’t think of the quiet withdrawn kid who says they are in pain, but people downplay it and tell them they are being lazy and to go to school, so they just do. Because so much of their life is adults telling them their life experience is not real.

This, 100%. My teen gets severe sore throats that no one can figure out. I think we are getting closer... The last ENT required us to see the pediatrician first to rule out strep/covid/ect. The nurse in the pediatrician's office lectured DC and me that they should be in school even if they were in too much pain to eat or talk. DC can barely drink when they flare. This was mid-covid. The school nurse and I had already come up with a plan; DC was not going to school if they could not eat a regular meal; but the pediatrician was really upset that DC was not in school! When we were in the appointment, DC was missing her college level foreign language class. DC couldn't have participated, asked questions, or even let the teacher know why they were not speaking. It was ridiculous! What teacher wants a kid in school who has such a sore throat they cannot talk? Especially in 2021! The pediatrician wouldn't be working, but they expect the kids to just "suck it up". We completely ignored the NP at the office, but DC will now not see a few practitioners because of this attitude!