Paging Dr. Hive... reflux, prilosec, and food not digesting....(tmi)

[East Coast Sue]

My ds 7.5 yrs old has been tested and confirmed that he has reflux (gastric emptying test). Once a day prilosec was not controlling his symptoms, so he is now on twice a day prilosec. He still wakes nearly every night and coughs/gags. We have eliminated tomatoes and fried, fatty, processed foods from his diet. He eats every 2.5 hours during the day and stops eating 3.5 hours before bedtime (not even a sip of water after dinner). We have put so many restrictions on his diet that I am concerned that he still experiences problems so regularly. I know that I need to contact his physician. However, I am wondering is it time to see a gastroenterologist? Currently, he is being treated by a pediatric pulmonologist for both reflux and asthma.

 

This weekend he ate a small amount (maybe 2-3 bites) of meat. Usually, he does not eat meat. The next day it was not digested (still visible when he eliminated it in the toliet!) Is this because the acid blocker is preventing him from digesting food? Is it a sign of a bigger problem? I'm not sure if this is something I need to address with the doctor who prescribed the acid blocker.

 

So, its time to contact his doctor, do I bring up the undigested meat as a concern? Do I need to move on to a pediatric gastro doctor? What else could be going on that his reflux isn't under control?

 

Thanks for your time!

[Paige]

I would ask for something else. Prilosec doesn't work for my girls. They did pretty well on prevacid for many years and then had a resurgence of symptoms. We tried prilosec but it didn't help and now they are on nexium. Nexium is keeping it under control for now. If nexium and prevacid don't work, maybe there's something new out. Reflux is tricky and the same drug won't work for everyone or even the same person all the time. I don't think anything else is necessarily going on, but I'm surprised that he hasn't seen a ped gastro doc yet at his age. FWIW, my girls have been seeing one off and on since they were babies and I don't think it has been any more helpful than just seeing our pediatrician.

[Random]

I think you should read about Eosinophilic Diseases.

 

I also think that acid reflux that severe is never just acid reflux.

 

As an aside, many times the child's problem is not that he is making too much acid and needs a PPI, but that he is not making enough acid and the PPIs exacerbate the problem. The fact that the PPI is preventing him from digesting food would seem to be a problem. How is his body supposed to get nutrients from the food he eats? And if he doesn't get nutrients, how is his body supposed to heal and grow?

 

For sure, move on to a GI. I sincerely hope you get a good one. My son's ped GI did much more to help him than the pediatrician could.

 

Best wishes to you on this journey.

[sbgrace]

A pediatric gastro would likely check for EOS disease as the previous poster mentioned.

 

My son was scoped for EOS because of failure to fully resolve reflux with meds. He has delayed gastric emptying and that was a lot of it. We raised the head of his bed 6 inches. I think it helps some.

 

We do digestive enzymes (plant based) because we know there are some malabsorption issues here. We also supplement with highly absorbable vitamins/minerals. I think you've probably got some malabsorption. I don't know that it would be solely due to the PPI but possibly. My son's issues in that area continued after we stopped PPI's.

 

I'd see GI. If you have a medical speciality like Integrative Medicine MD's in your state it might be worth seeing someone to look at things a little more holistically. That has been a great help for us anyway.

[curlgirl]

My husband has GERD but I have no experience with these issues in a child. So feel free to take this with a grain of salt. :) Have you tried a probiotic? My husband said that the feeling of fullness (he also has slow digestion) and bloating seem to abate with a probiotic. Just a thought. I know how difficult dealing with an adult's flareups are and I can only imagine the discouragement you feel dealing with it in your child. Also, our gastro dr. referred him to an allergy specialist because sometimes that can make GERD worse. Maybe that could be an option? Like I said so sorry for you. :grouphug:

[applethyme]

I would take him to see a peds gi doctor. My son had similar issues and we saw both a gi doctor and a doctor that specializes in motility.

[Luckymama]

The three members of this family take three different reflux meds. It could be that he might need to trial a different one. Prilosec did absolutely nothing for older dd while Nexium worked the very next day.

[Staceyshoe]

My thought was EGID as well. A GI will do an endoscopy, and you'll have an answer. The symptoms greatly overlap GERD, but if eosinophils are the problem then GERD treatment isn't adequate treatment. We've been through this with my ds. Feel free to contact me if you have specific questions.