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What is this pain ?

P

paul33

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Mar 2, 2015
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First of all let me point out that this post is about my teenage daughter, not myself.

Second, my daughter is an Emetophobia sufferer so feel free to move this to a more appropriate forum if required but Emetophobia is an anxiety disorder and not an eating disorder.

My daughter has suffered from diagnosed Emetophobia for five years and her particular twist on the phobia is that she has always associated eating with a risk of nausea so in her darker early days, she struggled to eat and lost a dangerous amount of weight.

She is much improved now and the core phobia appears to be weaker such that she can live a reasonably normal life and eat reasonably well and certainly enough to hold her weight steady but she is trying to put more weight on.

Eighteen months ago she started complaining of increasing amounts of "pain" after eating and this pain has become more of an issue in the last year than her phobia and offers its own deterrent to eating.

Local adolescent mental health therapists - who openly admit to knowing very little about Emetophobia - have consistently dismissed this pain as "not real" and a mere figment of her disturbed mental state (which infuriates and upsets my daughter !).

I understand why they might say that but I have observed her "in pain" plus she is on anti-depressants which do work very well so why would she be making this up ?

She has had physical tests at the hospital too and, whilst not 100% conclusive, they have shown nothing abnormal that might be causing the pain.

The only two explanations that I have heard that make some sense is that (a) it is a form of IBS whereby it is an anxiety driven pain and (b) it is a response from the digestive system to eating normally after years of under-eating and will continue until she has put on more weight.

The reason for this long winded post (sorry !) is to ask if anybody has experienced anything similar regarding pain from eating when recovering from a low weight.

We are all at our wits end at the moment - my daughter is on the verge of "giving up" - and no medical staff seem prepared or equipped to do anything about it or even agree what it is.

Any help really appreciated !
 
Kerome

Kerome

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If it is an anxiety driven pain, you could try keeping a mood journal and trying different techniques to reduce anxiety around eating, like music, binaural beats, or even an experiment with hypnosis. If it is physical you could try different kinds of food, like soups or mashed potatoes rather than anything in heavy chunks. Either way, I'd keep good records of both her mental state and the physical substances that she eats, maybe a pattern will reveal itself?
 
SarahD

SarahD

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Hi Paul, while it does look as if the pain could be related to anxiety, I think I would want to be absolutely sure there is no physical cause. What tests did she have at the hospital? Who ordered them? If it was your GP I would press for a referral to a gastroenterologist. It is rare for there to be a serious problem at your daughter's age, but it is not impossible.

Is the pain soon after eating or after quite some time? And how high up is the pain? I think she should have maybe an endoscopy, or a colonoscopy depending on the specialist advice, and maybe a CT scan. There are other tests, for instance where you swallow a small camera, that can look at the small intestine which is hard to see in other tests.

This may seem over the top, but I have a friend who had stomach cancer in her early 20s. My ex partner had a rare cancer in the small intestine (although much older) and we had to push for every test so that it took a year to get a diagnosis. It is extremely unlikely that your daughter has cancer. There are other physical problems, even a hiatus hernia can cause pain after eating, or the valve at the end of the oesophogus may let acid back up.

Once you have a mental health problem it is easy to assume things happen because of that.

In the meantime frequent smaller meals may help avoid the pain.
 
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paul33

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I have tried to get my daughter to keep a diary before but it isn't easy because she is a teen and teen's don't like playing ball especially when they think nobody is listening to them. She claims not to have any "worries" or "anxieties" and, on the face of it, she really is a happy go lucky cheerful person most days with no obvious sign of any issues. She also points out that she is on very effective anti-depressants so how can she have anxieties ?

I would love to see hypnosis tried because it would - presumably - reveal anything she is not telling us but how would I gain access to hypnosis ? I presume the NHS wouldn't subscribe to or offer it !

As for hospital treatment, she has had all the usual blood tests, stool samples plus abdominal scans and that's about it. She won't have barium meal type tests because of risks of nausea and she came very close to having a camera down the throat but a nurse came out just before and pointed out that the general anaesthetic "might make her feel sick" which was a crass thing to say to an emetophobia sufferer (but which happens all the time) and she walked out at that point !!!

She says the pain is generally above the stomach and is more like a feeling of wind but she's tried all the over the counter Wind-Eze, Rennie type stuff.
 
Kerome

Kerome

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Effective anti depressants, lol, well I am glad to hear it. More often around here we see people complaining that their medicines are not working for them.

Perhaps with the mood journal you can pitch it as not being a diary but more a scientific experiment, where you take readings about yourself for specific things, like how happy am I on a scale of 1-10, how anxious do I feel about eating and so on. Whatever questions seem relevant. Then afterwards you note down how painful it was, and perhaps you can discover a pattern, such as anxious greater than 6 then it hurts a lot.

As for hypnosis, I'd suggest finding a private hypnotherapist in the area and getting a few sessions that way. They are often not that expensive.
 
S

sadgirl

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Could be an ulcer or stomach problem due to the amount she eats that combined with stress (I know that she says that she doesn't have any but you show me a teenager with out any lol) but seriously I'd keep on at them the mental health team doctors ect
 
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