Frequent Bathoom trips?

[myrose]

Hello everyone. My daugter just started kindergarten in a new school. I have slowly began to meet all the other Moms. Tonight at soccer practice I got deeply involved in a conversation with one of the Moms. We somehow started talking about our kids and I told her the whole story about my daughter. She was really in disbelief. She said she would have never guessed anything like that. I told her she is on topamax now and it took everything away.

Anyhow why I am writing is because she told me her daughter has been making frequent trips to the bathroom but mostly never produces anything.

She said she just always feels the need to go (urge) She said she had her tested for a URI several times and also visited a urinologost (sure I spelled that wrong)

and everything always comes back normal.

She has no signs of OCD, tics, or anything. The only problem is with the urge to pee. I immediately thought Pandas because I have read that the urge thing is a classic sign. She never heard of Pandas. There are also no other symptoms????

I told her about this board and said I would write in tonight and ask tonight.

 

Anyone have any clues???? at all???

 

She may actaulyl come on here...I am hoping she does. It would be nice to know someone on here!

Thanks everyone!

 

We are still doing great! My daughter LOVES Kindergarten! The second week of school she got STUDENT OF THE WEEK AWARD and she just got a score of 100 on her second spelling test!!! Also made her FIRST GOAL in soccer tonight. I am so dam proud of this little thing. Makes me tear up but this time around...THEY ARE TEARS OF JOY!!!!!!!!!!!!!!!!!!!!!!!!!!!!

[momto2pandas]

Interstitial cystitis. Sounds like that to me, anyway.

 

I just looked for a web page that give a description of IC in children and found this: http://www.ichelp.org/Default.aspx?tabid=231. I hope that her physician considered this.

 

Where did you find the information that frequent urination is a symptom of PANDAS? Interstitial cystitis is sometimes associated with other the auto-immune/anxiety disorder complex that I've been studying, by the way.

[EAMom]

Frequent urination/urgency can sometimes be the *only* sign of PANDAS. I would rec. a throat culture...do the 48-72 hr culture if the rapid is neg.

 

My daughter had PANDAS Anorexia Nervosa, OCD, psychosis, etc. Jan 08-June 08 (2nd grade)...

 

When she was in preschool she had an episode where she was acting like she had a bladder infection. It was an overnight change (she had up until then been the type of kid who only peed 2-3x daily)...I took her to the pediatrician 2-3x...they assured me it was not a bladder infection. Eventually (weeks later) she gradually improved on her own. I realize now that could have been our first PANDAS episode (no throat culture was done of course, only a urine sample).

 

A lot of kids get strep with no symptoms (no sore throat, no fever etc.).

[michele]

The frequency to want to try to urinate was always a sign for me that my son was beginning a PANDAS episode or had been exposed to strep. He even got this while on Pen VK prophylaxis for the PANDAS. However, on Omnicef he does not have the urge to go pee over and over where nothing really happens. I also had him tested for urinary infection and all was neg. Psychologis said it may just be a sign of OCD. However, OCD is worse during episodes so it does make sense. It wouldn't hurt for her to get a strep culture. Tell her to document the time and length of duration. I saw a pattern after this happened a few times. It was helpful to look back on for the Dr.

 

Michele

Hello everyone. My daugter just started kindergarten in a new school. I have slowly began to meet all the other Moms. Tonight at soccer practice I got deeply involved in a conversation with one of the Moms. We somehow started talking about our kids and I told her the whole story about my daughter. She was really in disbelief. She said she would have never guessed anything like that. I told her she is on topamax now and it took everything away.

Anyhow why I am writing is because she told me her daughter has been making frequent trips to the bathroom but mostly never produces anything.

She said she just always feels the need to go (urge) She said she had her tested for a URI several times and also visited a urinologost (sure I spelled that wrong)

and everything always comes back normal.

She has no signs of OCD, tics, or anything. The only problem is with the urge to pee. I immediately thought Pandas because I have read that the urge thing is a classic sign. She never heard of Pandas. There are also no other symptoms????

I told her about this board and said I would write in tonight and ask tonight.

 

Anyone have any clues???? at all???

 

She may actaulyl come on here...I am hoping she does. It would be nice to know someone on here!

Thanks everyone!

 

We are still doing great! My daughter LOVES Kindergarten! The second week of school she got STUDENT OF THE WEEK AWARD and she just got a score of 100 on her second spelling test!!! Also made her FIRST GOAL in soccer tonight. I am so dam proud of this little thing. Makes me tear up but this time around...THEY ARE TEARS OF JOY!!!!!!!!!!!!!!!!!!!!!!!!!!!!

[EAMom]

Anyway, a throat culture is a very benign easy thing to do...much more so than some of others tests they could be running on her!

[ratlenhum]

Prospective identification and treatment of children with pediatric autoimmune neuropsychiatric disorder associated with group A streptococcal infection (PANDAS).

Arch Pediatr Adolesc Med. 2002 Apr;156(4):356-61.

"BACKGROUND: The current diagnostic criteria for pediatric autoimmune neuropsychiatric disorder associated with group A streptococcal infection (PANDAS) are pediatric onset, neuropsychiatric disorder (obsessive-compulsive disorder [OCD]) and/or tic disorder; abrupt onset and/or episodic course of symptoms; association with group A beta-hemolytic streptococcal (GABHS) infection; and association with neurological abnormalities (motoric hyperactivity or adventitious movements, including choreiform movements or tics). OBJECTIVE: To assess new-onset PANDAS cases in relation to acute GABHS tonsillopharyngitis. DESIGN: Prospective PANDAS case identification and follow-up. RESULTS: Over a 3-year period (1998-2000), we identified 12 school-aged children with new-onset PANDAS. Each patient had the abrupt appearance of severe OCD behaviors, accompanied by mild symptoms and signs of acute GABHS tonsillopharyngitis. Throat swabs tested positive for GABHS by rapid antigen detection and/or were culture positive. The GABHS serologic tests, when performed (n = 3), showed very high antideoxyribonuclease antibody titers. Mean age at presentation was 7 years (age range, 5-11 years). In children treated with antibiotics effective in eradicating GABHS infection at the sentinel episode, OCD symptoms promptly disappeared. Follow-up throat cultures negative for GABHS were obtained prospectively after the first PANDAS episode. Recurrence of OCD symptoms was seen in 6 patients; each recurrence was associated with evidence of acute GABHS infection and responded to antibiotic therapy, supporting the premise that these patients were not GABHS carriers. The OCD behaviors exhibited included hand washing and preoccupation with germs, but daytime urinary urgency and frequency without dysuria, fever, or incontinence were the most notable symptoms in our series (58% of patients). Symptoms disappeared at night, and urinalysis and urine cultures were negative. CONCLUSION: To our knowledge, this is the first prospective study to confirm that PANDAS is associated with acute GABHS tonsillopharyngitis and responds to appropriate antibiotic therapy at the sentinel episode."

[Caryn]

My son had frequent urination problems and does not have Pandas. He had bed wetting issues and day time wetting issues that resolved when we changed his diet. Urinary problems can also be due to physical issues as well. I had a bilateral reflex to the kidney that was corrected through surgery at age 6. Symptoms included urinary tract infections, bacterial infections, and episodes of very high fevers. I was quite sickly prior to diagnosis.

I think we may need to be careful about pinning wetting issues on PANDAS.

There can be multiple causes.

[Chemar]

yes I would absolutely agree that frequent urination can have many varied causes and that one needs to be very cautious about assuming PANDAS without comprehensive diagnostic evidence

 

kidney infections or anatomical problems can also lead to frequent and urgent need to urinate/bed wetting etc and so a careful medical evaluation to check on all symptoms is really a good idea

[EAMom]

Nobody in this set of posts has suggested that PANDAS is the only cause of daytime urinary urgency/frequency.

 

We are simply saying that PANDAS is something that should be considered when such symptoms arise. (Thank you Ratlenhum for posting the paper I was thinking of!) In the situation Myrose described, the child in question had already visited a urologist (who I assume did a full urinalysis/urine culture and whatever other tests/workup he found appropriate) and not find the cause of the problem.

 

Michele, ratlenhum, and I are simply recommending that PANDAS not be overlooked as a possible cause of this child's symptoms.

 

Personally, knowing what I know now, if my child were to present with sudden urinary urgency/frequency I would request both a urinalysis and a throat culture. Certainly, if neither of those were helpful, I would pursue other appropriate (undoubtedly more expensive and invasive) diagnostics to get to the root of the problem.

[michele]

I had meant to reply to this link again but something happened to my post. I agree with you both Dr. Murphy from UF Shands told me this is typically one of the first symptoms PANDAS patients present with. My son did have urgency to frequent the toilet when he had episodes of strep. I did test him for infections of the bladder/urine and they were all negative also. OCD PANDAS can be a cause of the urgency to try to urinate. It seemed like a compulsive behavior to run in and out of the bathroom. Thank you for the link ratlehum. I had not seen that before and it really made sense in our case to why he had the urgency but nothing came out. It really threw our ped and us as to why it was happening. However while on omnicef his urgency has gone away and not returned. And yes our urgency was only during the day. I agree check out all avenues but just beaware there is a strep/ocd connection with the need to freel they need to urinate and nothing really comes out.

 

Nobody in this set of posts has suggested that PANDAS is the only cause of daytime urinary urgency/frequency.

 

We are simply saying that PANDAS is something that should be considered when such symptoms arise. (Thank you Ratlenhum for posting the paper I was thinking of!) In the situation Myrose described, the child in question had already visited a urologist (who I assume did a full urinalysis/urine culture and whatever other tests/workup he found appropriate) and not find the cause of the problem.

 

Michele, ratlenhum, and I are simply recommending that PANDAS not be overlooked as a possible cause of this child's symptoms.

 

Personally, knowing what I know now, if my child were to present with sudden urinary urgency/frequency I would request both a urinalysis and a throat culture. Certainly, if neither of those were helpful, I would pursue other appropriate (undoubtedly more expensive and invasive) diagnostics to get to the root of the problem.

[Chemar]

yes, the urinary issues are clearly recognized as a PANDAS symptom, so that is not being in any way disputed.

 

the concern is just that some new members read posts here and can become very confused, so Caryn and I were only suggesting that one has to look carefully at the whole picture, as the original post myrose made related to a child who does *not* yet have a clear diagnosis. Where discussing these things on forums the way we do often leads to invaluable insights that help with diagnoses and treatments, we still do have to urge everyone to consult with a qualified health practitioner for diagnosis and treatment. Doctors arent always clued up yes, and that is where taking the info gleaned here to them can often be so very helpful. But we do have to be very careful not to diagnose or prescribe for one another's kids.