endoscopy for refux

[caedmyn]

Has anyone's child had an endoscopy done for reflux?  Did it help determine the cause of the reflux?  My 4 YO's GI doctor wants to do an endoscopy for his reflux and I'm wondering what to expect and if there's really a point in doing it.  I feel like it's just the latest in the list of things to try, none of which has actually done anything to fix or find the cause of the refluxing.

[aaplank]

Yes. An endoscopy is done to hopefully find the cause in order to fix the problem. When my daughter had it done, I got to see the recorded video of the endoscopy and I was given several pages of screenshot pictures that showed the anomalies in her GI tract.

[Carrie12345]

My dd had an endoscopy with barium swallow as an infant.  It wasn't *pleasant, but they were able to rule out any abnormalities that might require surgery.

[SparklyUnicorn]

Yes. An endoscopy is done to hopefully find the cause in order to fix the problem. When my daughter had it done, I got to see the recorded video of the endoscopy and I was given several pages of screenshot pictures that showed the anomalies in her GI tract.

 

What fixes are there though? 

This is my beef with endoscopy. I told my GI I won't do any procedures that won't lead to a fix for my problem. 

 

I'm seeing my GI today so I'm going to ask again what the endoscopy stuff would be for exactly.  I am going to pursue testing because I want to see if I qualify for LINX.  Otherwise, I'd see no point in doing it.

[SparklyUnicorn]

Has anyone's child had an endoscopy done for reflux?  Did it help determine the cause of the reflux?  My 4 YO's GI doctor wants to do an endoscopy for his reflux and I'm wondering what to expect and if there's really a point in doing it.  I feel like it's just the latest in the list of things to try, none of which has actually done anything to fix or find the cause of the refluxing.

 

I will ask the doc again.  When I asked him last time he told me it was to check for cancer.  At the risk of sounding kinda crazy, I don't really give a rat's arse about checking for esophageal cancer because it's extremely rare and if I have it I'll probably die from it because the prognosis is very poor.

 

But if the treatment is drugs in the end, I'm already on drugs.  So you are going to subject me to testing that is expensive and I'm not keen on doing to keep me on drugs anyway?  No thank you.

 

I was told the procedure is not painful though. 

[ktgrok]

It also determines how bad the damage is. What drugs are used, and if you should pursue surgery instead, is partly determined by how bad the damage is. They are also looking for anatomical abnormalities that might be part of the problem. 

Edited June 27, 2017 by ktgrok

[SparklyUnicorn]

It also determines how bad the damage is. What drugs are used, and if you should pursue surgery instead, is partly determined by how bad the damage is. They are also looking for anatomical abnormalities that might be part of the problem. 

 

All the drugs are pretty much the same.  They shut off the acid production or lower acidity. 

 

In terms of surgery, they won't perform some of those things on kids.  I asked why they can't just repair a HH and have that fix the problem.  I was told they often don't bother because it doesn't last. 

 

I'd probably go ahead with the procedure for a kid for the simple fact I don't to be accused of not taking action for my kid, but for me I have no qualms about saying no to stuff that won't lead to something different. 

[caedmyn]

I'm feeling like we should be going with a naturopath instead of a MD at this point, because the MDs haven't done anything for him.  Maybe we'll get the endoscopy done to rule out whatever, and then try to find a decent naturopath.  And I'm not keen on having him on acid reducers indefinitely, especially when they don't even stop the refluxing.  They reduce it, and make it quieter, but they don't stop it.  And no one seems to be able to explain, or even seems all that interested in, why the refluxing seems to randomly get better and then (much) worse.  It seems clear to me that something is causing, or at least affecting it, but it doesn't seem like that angle is being pursued at all.

[SparklyUnicorn]

I'm feeling like we should be going with a naturopath instead of a MD at this point, because the MDs haven't done anything for him.  Maybe we'll get the endoscopy done to rule out whatever, and then try to find a decent naturopath.  And I'm not keen on having him on acid reducers indefinitely, especially when they don't even stop the refluxing.  They reduce it, and make it quieter, but they don't stop it.  And no one seems to be able to explain, or even seems all that interested in, why the refluxing seems to randomly get better and then (much) worse.  It seems clear to me that something is causing, or at least affecting it, but it doesn't seem like that angle is being pursued at all.

 

This shi* is ruining my life.  Seriously.  I have read whatever I could find and I don't think anyone quite knows what the deal is.  My son also has this issue (he's 15 and was on Zantac as a baby).  He can get by with occasional Pepcid AC (as I did when I was a kid although they didn't have those drugs when I was that age so I just took antacids).  It only seems to be getting worse.  My mother had this and her brother.  I'm convinced it is genetic.

 

I have an acquaintance locally who has offered me her services.  She's a chiro and big into naturopathy.  After talking to her I am convinced she cannot help me.  She said stuff like one should eat a lot of raw vegetables for the enzymes.  I eat a ton of raw vegetables.  I mean literally word for word I've been doing everything she said I should do to fix the problem and none of it is helping. 

 

Of course it is worth a shot, but honestly I do not believe it is going to be magical.  And there is also such a thing as silent reflux.  The symptoms are very minimal or one doesn't notice, but the damage is still being done.  So yeah maybe some people can manage to reduce the noticeable symptoms, but this doesn't mean they are actually cured. 

 

That's why I'm asking about LINX.  They won't do that on a kid, but maybe something to think about for later on if nothing else works. 

Edited June 27, 2017 by SparklyUnicorn

[caedmyn]

Have you read about low stomach acid being a possible cause of reflux?  I know for myself I had problems with reflux for a while when DD was a baby and doing what was recommended for low stomach acid completely got rid of the refluxing.  There's actually a test to measure your stomach acid levels.  It sounds like not many doctors do it but that's something else I wanted to ask his GI doctor about.  I'm reluctant to experiment with trying to increase stomach acid levels myself with a kid who isn't old enough to really communicate how he feels, and already has severe reflux at times. But that is what I am wondering might be going on with him...either that or food intolerances causing it, because I know certain foods make it worse and certain foods caused him to spit up a ton as a baby, and certain foods still cause his brother who was a projectile vomiter as a baby to reflux occasionally.  But either he's super sensitive and I can't control his diet well enough to get him to stop refluxing, or a food I haven't identified is a cause (assuming it's food as the cause).  

[SparklyUnicorn]

Have you read about low stomach acid being a possible cause of reflux?  I know for myself I had problems with reflux for a while when DD was a baby and doing what was recommended for low stomach acid completely got rid of the refluxing.  There's actually a test to measure your stomach acid levels.  It sounds like not many doctors do it but that's something else I wanted to ask his GI doctor about.  I'm reluctant to experiment with trying to increase stomach acid levels myself with a kid who isn't old enough to really communicate how he feels, and already has severe reflux at times. But that is what I am wondering might be going on with him...either that or food intolerances causing it, because I know certain foods make it worse and certain foods caused him to spit up a ton as a baby, and certain foods still cause his brother who was a projectile vomiter as a baby to reflux occasionally.  But either he's super sensitive and I can't control his diet well enough to get him to stop refluxing, or a food I haven't identified is a cause (assuming it's food as the cause).  

 

I have heard of that.  My doc didn't do more than various blood tests and an ultrasound.  He was basically just checking that I didn't have deficiencies or some serious problem that might be indicated with CBC counts that were off.  The ultrasound checked my other organs.  But in terms of anything related to the flux..nope not really.

 

I leave for my appointment now. I'll ask about this too.

[itsheresomewhere]

DH has had several. The last one finally showed what I suspected all along was that he had low acid. They are not painful and I would get it done. DS may need one in the next year and I have no problems with it.

[Lanny]

If that cannot find the issue probably nothing will? I   had an examination, I think this was 10 or 15 years ago, when we had much better medical coverage, that my Gastroenterologist did.  Where they stick something down your throat. That sounds horrible, but I do not remember that it was like torture or something. It was not that bad. Not something that was enjoyable, but not painful or anything that I would remember.

 

But for a 4 year old, it might be more traumatic and hopefully can be explained in simple terms, why they need to do it.  

 

RE: Reflux   They really do need to determine the cause. That can cause Cancer.  When we had the better insurance, our ENT doctor had a patient, a young Dentist, a man who had never smoked, who had throat or mouth Cancer. The only thing she could think of that caused his Cancer was that he had Reflux.   The subject came up, because my Stepson had Reflux and she was trying to get him to modify his habits, like eating and then laying down on top of the bed.

[Lady Florida.]

I don't know if I'd put a child through it. I had one as an adult and it really doesn't do anything except tell the doctor, "Yep. Just as you suspected. This patient has acid reflux". The treatment isn't any different IME than a dx without the endoscopy.

 

It can be used to check for Barret's Esophagus and hiatal hernia but for the most part it's an overused procedure.

Edited June 27, 2017 by Lady Florida.

[Nemom]

An endoscopy can be used to rule out certain diseases that could be causing the reflux such as Eosinophilic Esophagitis.  Trust me, if your son has this disease, you are better off finding out at the age of 4 rather than 8.  Starting treatment early will be much easier for your child.  

 

My dd14 has 3-4 endoscopies every year to manage the disease.  The procedure is very quick-maybe 10 minutes-in the OR.  The majority of the time is spent in recovery.  She wakes up with a sore throat but that is usually gone by the end of the day.  

 

Most children's hospitals are very good when it comes to putting these kids under anesthesia.  You will likely have the option to have him drink some "sleepy" medicine beforehand.  They can be given a mask that smells like bubble gum, strawberry or whatever flavor he chooses to help him fall asleep as well.  The hospital we go to allows us to walk back to the OR with her and stay while she starts to fall asleep.  The Dr's tell her jokes and do everything they can to help her relax while she is still awake.

 

 

[scbusf]

I don't know if I'd put a child through it. I had one as an adult and it really doesn't do anything except tell the doctor, "Yep. Just as you suspected. This patient has acid reflux". The treatment isn't any different IME than a dx without the endoscopy.

 

It can be used to check for Barret's Esophagus and hiatal hernia but for the most part it's an overused procedure.

 

I tend to agree with this. I had one and yes, it confirmed reflux. Um, OK, I already knew that. Here's $800.

[ktgrok]

Yes to the eosinophilac esophagitis. I know two children with this, and treatment IS different from standard reflux from what I understand. Plus, of course, you want to be sure there is nothing cancerous going on. 

[SparklyUnicorn]

Yes to the eosinophilac esophagitis. I know two children with this, and treatment IS different from standard reflux from what I understand. Plus, of course, you want to be sure there is nothing cancerous going on. 

 

 

The diagnosis is confirmed by biopsy of the esophagus. The treatment of eosinophilic esophagitis is with proton pump inhibitors and swallowed fluticasone propionate. Gentle esophageal dilatation is used when meditations fail to relieve dysphagia.Feb 23, 2016

Eosinophilic Esophagitis: Facts on Causes, Symptoms & Diet

www.medicinenet.com/eosinophilic_esophagitis/article.htm

[SparklyUnicorn]

I would totally do the scope.  I'm absolutely not suggesting do not do it.  Just saying for them to claim there is some sort of different treatment, there is no different treatment barring them finding something else wrong. 

 

[applethyme]

My son's reflux was so bad that he did have surgery to correct it. The procedure is called a Nissen Fundleplaction. 

[Nemom]

 

The diagnosis is confirmed by biopsy of the esophagus. The treatment of eosinophilic esophagitis is with proton pump inhibitors and swallowed fluticasone propionate. Gentle esophageal dilatation is used when meditations fail to relieve dysphagia.Feb 23, 2016

Eosinophilic Esophagitis: Facts on Causes, Symptoms & Diet

www.medicinenet.com/eosinophilic_esophagitis/article.htm

 

 

Sorry, not a great article to refer to too.  Try these websites:  apfed.org  and  https://www.cincinnatichildrens.org/service/c/eosinophilic-disorders

 

 

My dd's EoE is NOT caused by reflux.  She has never been on PPI's or swallowed steroids.  She has never, nor do I ever hear of, Dr's doing the dilatation anymore.  Many children opt to have their EoE managed through diet and/or elemental formula.

 

Also, a large majority of the patients are asymptomatic and do not have dysphagia or many of the other symptoms. It was only through endoscopy that we discovered my dd had EoE after six years of many dr visits and tests.

 

(We travel to Cincinnati for her disease management and they are considered one of the top two hospitals in research and treating the disease.)

[PinkyandtheBrains.]

One of my boys had it done at the same time as a colonoscopy to rule out several issues including reflux. In our case, it was done at the children's hospital under anesthesia.  The endoscopy ruled out reflux, identified another issue, and we were able to process accordingly. 

[caedmyn]

So this page http://www.eosinophilicesophagitishome.org/eosinophilic_esophagitis_diagnosis/eoe_diagnosis_upper_endoscopy/ is talking about having an endoscopy done after they have been on PPIs for a while (and apparently while not having a bunch of inflammation from the refluxing?).  So does that mean that an endoscopy done while he's on Zantac, or not on anything, cannot accurately determine if he has EE?  The pediatric GI doctor wanted him on Zantac for 2 months and said after that we should stop it and see if the refluxing returned (not that the Zantac ever stopped the refluxing anyway...it just made it quieter, and sometimes he didn't reflux very much while on it, but sometimes he did).  He's never been on PPIs.  I'm not sure it's technically refluxing that he's doing, it's regurgitation.  Before he started Zantac every time he ate you could hear food coming back up over and over...literally hundreds of times a day, but he wasn't in pain.

[SparklyUnicorn]

Sorry, not a great article to refer to too.  Try these websites:  apfed.org  and  https://www.cincinnatichildrens.org/service/c/eosinophilic-disorders

 

 

My dd's EoE is NOT caused by reflux.  She has never been on PPI's or swallowed steroids.  She has never, nor do I ever hear of, Dr's doing the dilatation anymore.  Many children opt to have their EoE managed through diet and/or elemental formula.

 

Also, a large majority of the patients are asymptomatic and do not have dysphagia or many of the other symptoms. It was only through endoscopy that we discovered my dd had EoE after six years of many dr visits and tests.

 

(We travel to Cincinnati for her disease management and they are considered one of the top two hospitals in research and treating the disease.)

 

So what does she use for the EE?  Or is there some other treatment for it?

[Nemom]

So what does she use for the EE?  Or is there some other treatment for it?

 

We opted for treatment through diet and elemental formula for several reasons.  She has never needed the PPI because she does not have reflux (until recently  :closedeyes: ).  

 

Just an FYI...EE is another unrelated disease.  EoE is the correct abbreviation.

[Nemom]

So this page http://www.eosinophilicesophagitishome.org/eosinophilic_esophagitis_diagnosis/eoe_diagnosis_upper_endoscopy/ is talking about having an endoscopy done after they have been on PPIs for a while (and apparently while not having a bunch of inflammation from the refluxing?).  So does that mean that an endoscopy done while he's on Zantac, or not on anything, cannot accurately determine if he has EE?  The pediatric GI doctor wanted him on Zantac for 2 months and said after that we should stop it and see if the refluxing returned (not that the Zantac ever stopped the refluxing anyway...it just made it quieter, and sometimes he didn't reflux very much while on it, but sometimes he did).  He's never been on PPIs.  I'm not sure it's technically refluxing that he's doing, it's regurgitation.  Before he started Zantac every time he ate you could hear food coming back up over and over...literally hundreds of times a day, but he wasn't in pain.

To receive or rule out a dx of EoE, he will need to be on a PPI for 6-8 weeks.  I would talk to your Dr about it before you scope.  Typically even if they find eosinophils through biopsy, they will not dx EoE if you have not been on a PPI.  If that happens, you could end up needing another scope after those 6-8 weeks.

 

My dd was not on a PPI first but reflux was completely ruled out with a 24 hour pH scope which is also acceptable.