2.5 year old with Silent Reflux

[FOURtunate]

My DS is 2.5 years old and has suffered from Silent Reflux since birth.

He is on 10ml of Losec twice a day, but our Paed is now concerned about his weightgain (or lack of), and the fact that he still gags/vomits/holds his food in his mouth.

We have been referred to a Paed Gastroenterologist at the Children's Hospital.

I am just wondering what the treatments are for Reflux at this age?

[RISA]

Hi,
Thanks for contacting RISA. Just as when your son was younger, there are probably a lot of different ways the dr can approach it, and it would also depend on whether he has pain with his reflux, or suffering from any other complications, and what treatments have been tried or investigations have been done at this point. Given that he is over 2, they will most likely take his ongoing reflux as more of an issue as they realise it needs to be managed, rather than ‘waiting to outgrow it’. (Our paed gastro told me that a child can grow out of reflux after the age of 2, but it is highly unlikely. He had seen it happen though)

Does he have any other signs of reflux, other than the weight gain and the feeding issues/vomiting/gagging? Does he look like he is in pain? Does he have behavioural issues (such as very sensitive, ‘loses the plot’ easily, temper tantrums, clingy or aggressive); sleeping issues, respiratory issues etc that could make you suspect the reflux is still causing major problems for him? Any issues he has would influence how aggressively the doctor treats it.

Depending on how he presents, the paed gastro may be happy to increase his medication, change it, or add others- there is a big range of doses that are used these days, and also a range of medications you can try that may possibly be more effective for him. He may refer your son to a speech therapist to try to sort out some of the feeding issues (or does he already see a speech therapist?), or a dietician. Do YOU feel as though the reflux is under control? Is he not putting on weight because he isn’t eating well, or because he vomits excessively? They may need to find what texture/thickness/temperature of the food he prefers and can give you some good suggestions to help with the feeding issues. At this stage, it is possibly a sensory issue, related to the reflux, rather than reflux on its own. My son when he was just over the age of 2, went to speech therapy because he had learnt to associate eating with pain, and because he had chewing problems (which they said he had missed in his development because of the reflux), so he preferred not to eat. It did help his eating significantly, though he did continue to struggle with reflux as well.

It’s also possible they will want to do some investigations, especially if he hasn’t had any yet- a barium swallow, an endoscopy, and/or a pH probe. Each doctor seems to have their own favourites and preferences regarding these, and will also depend on if there is any extra information they require.

There are a very small percentage of children at that age who need surgery for their reflux so that also needs to be mentioned, but it isn’t the answer for everyone, and it is only ever used as a last resort.

There may be other options too, of course, depending on your son's specific case.

I hope you find something that helps and you don’t have to wait too long to see the paed gastro (I always hated that part!!) I always found it better when I sat down and worked out what I expected from the appointment- what do YOU want to see happen? If it’s not mentioned, then find out why. Is there anything you specifically want to discuss? Write a list, and don’t be afraid to pull it out during the appointment. There’s nothing worse than coming out of the appointment and remembering something important you had wanted to mention!!!

Hope that helps

Glenda