Guest guest Posted January 21, 2008 Report Share Posted January 21, 2008 Hello, I have an 11 year old girl patient. Her father booked her in with 'an irritable bowel'. However, it pretty quickly became clear, that the main problem for her at the moment is that she is fainting up to 5 times a day at school. 'irritable bowel' onset 4 years ago, more or less coinciding with unhappy house move and (I'm guessing - too sensitive to discuss in 1st appt) divorce. She lives with Dad, and has contact with Mum. Symptoms - gripping, squeezing pain in the abdomen (constant, not spasmodic), some constipation, sometimes diarrhoea. The pain comes on suddenly, and seems to occur either while she eats, in response to particular foods, or after eating, it wears off gradually over an hour or so. The fainting started a year ago, no obvious reason. At first it occurred without warning, now, it seems to follow the abdominal cramping. The fainting only occurs at school. Not at home, even during holidays and weekends. It is getting worse, and has recently led to a hospital admission when school couldn't revive her. Hospital investigations -NAD for epilepsy, cardiovascular, neurology, gastroenterology, coeliacs, anaemia, etc. Only finding of note 'a narrowed section of the intestines' Other points of note in case history:- 'prickly heat' rash (father's description). Little itchy bumps all over torso in response to showering and rubbing with a towel. Father says he has the same. Family history of note:- mother was diagnosed with Coeliac's as a child - but then grew out of it (?). Periods not started yet,and no obvious cyclical nature to symptoms. Diet not great, but not particularly bad. Too much bread, and sweet snacks between meals, but proper cooked meals and no fizzy or caffeine drinks. She is thin, and, because certain foods (no obvious food groups) bring on the pain, already has a very restricted diet. I didn't want to make changes there yet. Rx. Chamomilla rec. Dioscorea, Scut lat.Stachys bet. Fillipendula, and Glycyrrhiza FE. Instructions to eat slowly and to chew each mouthfull really well (with explainations). Any ideas about this welcome. I'm assuming there is a strong psychological/stress componant, but I don't want to overlook anything. Thanks Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 21, 2008 Report Share Posted January 21, 2008 Hi , Could there be a hyperventilation component? I have certainly seen that cause blackouts in patients in hospital and have just started the practitioner training in Buteyko method- It certainly helps with anxiety, panic attacks and IBS as well as asthma. Look at buteyko.com for links and info. Zoe --- Firnberg wrote: > Hello, > > I have an 11 year old girl patient. Her father > booked her in with 'an irritable bowel'. However, > it pretty quickly became clear, that the main > problem for her at the moment is that she is > fainting up to 5 times a day at school. > > 'irritable bowel' onset 4 years ago, more or less > coinciding with unhappy house move and (I'm guessing > - too sensitive to discuss in 1st appt) divorce. She > lives with Dad, and has contact with Mum. > Symptoms - gripping, squeezing pain in the abdomen > (constant, not spasmodic), some constipation, > sometimes diarrhoea. The pain comes on suddenly, > and seems to occur either while she eats, in > response to particular foods, or after eating, it > wears off gradually over an hour or so. > > The fainting started a year ago, no obvious reason. > At first it occurred without warning, now, it seems > to follow the abdominal cramping. The fainting only > occurs at school. Not at home, even during holidays > and weekends. It is getting worse, and has recently > led to a hospital admission when school couldn't > revive her. > Hospital investigations -NAD for epilepsy, > cardiovascular, neurology, gastroenterology, > coeliacs, anaemia, etc. Only finding of note 'a > narrowed section of the intestines' > > Other points of note in case history:- 'prickly > heat' rash (father's description). Little itchy > bumps all over torso in response to showering and > rubbing with a towel. Father says he has the same. > Family history of note:- mother was diagnosed with > Coeliac's as a child - but then grew out of it (?). > Periods not started yet,and no obvious cyclical > nature to symptoms. > > Diet not great, but not particularly bad. Too much > bread, and sweet snacks between meals, but proper > cooked meals and no fizzy or caffeine drinks. She > is thin, and, because certain foods (no obvious food > groups) bring on the pain, already has a very > restricted diet. I didn't want to make changes > there yet. > > Rx. Chamomilla rec. Dioscorea, Scut lat.Stachys > bet. Fillipendula, and Glycyrrhiza FE. > Instructions to eat slowly and to chew each > mouthfull really well (with explainations). > > Any ideas about this welcome. I'm assuming there is > a strong psychological/stress componant, but I don't > want to overlook anything. > > Thanks > > > > > > > [Non-text portions of this message have been > removed] > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 21, 2008 Report Share Posted January 21, 2008 >> Could there be a hyperventilation component? .. . . Buteyko method- It certainly helps with anxiety, panic attacks and IBS as well as asthma. Look at buteyko.com for links and info. Thanks Zoe, That's a good idea. I read up on the Buteyko method for an asthma patient but it hadn't occurred to me for this patient. I'll check it out. .Any idea about how I could check whether it's applicable in her case? Should I ask about whether she feels short of breath just before fainting . .? I'll check the info on the site. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 21, 2008 Report Share Posted January 21, 2008 Try to observe her breathing (without her realising is best) over a minute. Count the resps per minute.(12-16 being normal) Over the space of a consultation watch the breathing pattern - is it regular? Does she cough, clear her throat, yawn lots, take lots of deep breaths/sighs, does she mouthbreath? These are all signs of disordered breathing patterns. Buteyko method is basically re establishing breathing patterns by nose breathing, shallow and gentle breathing and resting between breaths. Set exercises of these are done 3xday for a month. Many hypervents also complain of a blocked nose. You could ask her if she finds it difficult to take a fullfilling breath or get short of breath or tight chested. Also I seem to remember, tingling in fingers is a sign of hyperventilation just before collapse. Check out cardiac coherence stuff too - it works on similar principles, a GP I work with uses it for anxiety stress and insomnia. Good luck Best Wishes and Kind Regards, Zoe Hawes Medical Herbalist MNIMH RGN Dip Phyt. www.herbaljournal.co.uk www.zoehawes.co.uk Bath 01761 439 920 > >> Could there be a hyperventilation component? > . . . Buteyko method- It certainly helps with > anxiety, panic attacks and IBS as well as asthma. > Look at buteyko.com for links and info. > > Thanks Zoe, That's a good idea. I read up on the Buteyko method for > an asthma patient but it hadn't occurred to me for this patient. > I'll check it out. .Any idea about how I could check whether it's > applicable in her case? Should I ask about whether she feels short > of breath just before fainting . .? I'll check the info on the site. > > > Quote Link to comment Share on other sites More sharing options...
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