has anyone had any dealing with ALKALINE REFLUX?

[mad4myboys]

having alot ofproblems with 9 month old ds2.Before i waffle on (i didnt get any response last time i asked around)just wondering if anyone knows anything about it or knows anyone with it?

[mad4myboys]

bump

[alypaly]

how do you know it is alkaline reflux...

[trellism]

Litmus paper?

Sorry, just bumping really.

[alypaly]

most reflux is acid. have you had this diagnosed by a specialist

[mad4myboys]

cutting a very long 9 month story short, it was very obvious he had reflux from birth (ds1 also had bad reflux) he was put on some meds and no improvment. Had a barium meal which showed severe reflux up to the mouth. So stronger meds given.No improvment on meds, he then went in for a ph study which showed no acid levels. Medication was altered and there was still no change. He then had a camera put down him (and up him as has other symptoms of his tummy that are still being investigated)The paed said there was damage to the oesophagus (sp) which must have been by the acid. This went on till he was 6 months old and the paed said 'oh he will just have to grow out of it'and just left it at that. I went to the gp who had been in agreement with me all the way through that something didnt add up. Anyway she referred him to evelina hosp. The specialist said he thought the reflux wasnt being managed properly, increased a large amount of meds and said he should improve in a week but he got worse. I spoke to him on the phone and he said he thinks ds2 probably has alkaline reflux and not acid reflux that he has been treated on. He is arranging for a test which i think was called a neo test which is a thorough ph study including alkaline. I spoke to my gp the other day and she said that it is possible that the damage seen by the camera could be from the alkaline as that can be just as damaging as acid. Cant really find any info about it, just wanting to find anyone that knows much about it really

[alypaly]

what damage has been done to his oesophagus...is it ulcers. so the ph levels showed no acid refluxing but did it show alkali....the only thing that would come up the oesophagus that is alkaline, is bile from the gall bladder. Bile is alkaline and can also cause heartburn in the same way. I had alkaline heartburn just b4 i had my gall bladder out 2.5 months ago.none of the antacids worked for me either.

[alypaly]

also if duodenal contents flow back that causes alkaline reflux and a dysfunctional pyloric sphincter can cause this problem. Did he have projectile vomiting when he was a baby. My DS1 did and they said if it continued they would ahve to put a small stitch in the sphincter to stop it from happening. Find a better consultant as constant burning from reflux is not good long term as it can cause lots of problems.
have a look under bile gastritis on internet and see what you can glean

[mad4myboys]

thanks so much for responding. The first ph study was just an acid one,showed no acid, The old paed said just that the oseophagus was 'damaged' did nt say anything else. That report never went to gp, am chasing the hosp for it to be faxed to specialist who is being very good 2 me. HE has also been very constipated since birth, does poo like rabbit and mucousy. He has to have docusate other wise he doesnt poo. Could the 2 be related at all?

[mad4myboys]

oh and also, no he has never projectiled. That is what ds1 used to do!

[alypaly]

how can doc just say damaged,without actually explaining what damage. I wouldnt have left his room until they had told me what the damage was. Put your foot down and ask for a proper report. u cant b treated like that. His poo sounds as if his impacted.
If his poo is mucousy( BTW how old is he) that could be a seperate issue. sometimes musousy poo is to do with fat malabsorption but it definitely needs looking at.

[mad4myboys]

he is 9 months old. When he was born he didnt pass much mecconium. His poos have always been like this. He gets bad stomach cramps. He sleeps very badly, up every couple of hours at night, tummy churning and gurgling and him crying, doesnt nap well either and cant stand being in buggy and car seat.

I have this afternoon got through to old hosp who hav finally faxed through the report to evelina at 4pm, the specialist was amazing! He rang me at 6pm and said the endoscopy and colonoscopy need to be redone and he will try to so the alkaine ph study at same time, prob be next month, at least he is on my side. Im so angry my poor baby has to under go ANOTHER general anesthetic (he had 3 before 6 months old!) and we have to go through it and have to explain to 3 yr old ds as we will have to stay away as along way from us. At least something is happening.

It really doesnt make sense what could be wrong though. Do you think 2 seperate issues?

He also cant tolerate milk, so on neocate, if he eats wheat or protein foods of ANY time he gets in alot of pain in his tummy so he is surviving on fruit, veg and rice! Shockiing his weight is ok. I just have to feed him little and often

[alypaly]

he could have slow motility through his gut which will tend to make him constipated .They can test for that by giving a barium meal and seeing how long it takes to empty from stomach...he could be have impacted stools which could give him the tummy pain. This wud show up on a scan as all the poo shows up clearly.
I hope u get it sorted,it must be awful for you and baby with the worry

[nightcat]

I am not an expert, but have looked into digestion for my ds. If you have no acid, then you wouldn't be able to digest protein well/at all. He might have deficiency of digestive enzymes (acids are mainly in the stomach, ie before duodenum). You should do anything to limit damage to esophagus, so if you know what he can't handle, leave it off until you get to the bottom of it. At least you are now in good hands. It might be, after the investigations, that his diet will have to adapted, or maybe enzymes prescribed.

[mad4myboys]

it is so so hard. Obviously the lack of sleep and ds1 just doesnt understand and very hard to share attention equally with this situation. He can eat fruit except apple, i think all veg, no meat, no types of fish, no beans, no lentils. He can eat corn and rice. it is so limited. im wondering if the endoscope will show enough of the problem?

[alypaly]

mad4myboys some baies have faecal impaction which can be a partial or total blockage of bowel. Obviously DS2 is not totally blocked as he is pooing although it rabbit droppings. That happens with impacted bowel and alsom if not enuf fluid in diet. has he had an ultrasound to see if he is impacted. if that is possible as your gp for some movicol paediatric sachets and see if those help

[mad4myboys]

he has had every type of laxative. We tried movicol and it just made him bent double in pain for days so we were told to take him off it. He hasnt had any type of scan. i dont understand why his poo is mucousy though. Also i really struggle with his feeds, i still have to wind him halfway through even now. he gets alot of trapped wind

[nightcat]

I would contact the paed or GP and ask if there are any enzymes suitable for this age, or a complete feed package you could use in the meantime, as he is clearly not digesting his food well.
In my ds, constipation was due to dairy overload, later we found out that he was also gluten-sensitive (gluten is a protein).

(I know a 4yo who lives mainly on prescribed feeds as she can't tolerate real food - and drs are still trying to work out what's wrong).

[mad4myboys]

how do they eat them? Its a nightmare as he is such a lovely laid back baby and if he wasnt poorley id have had such a great time with motherhood esp after having bad time with ds1.

Im hoping that when they put the cameras in him it will show up whatever is/isnt going on are am i being bit naive?

[nightcat]

The feeds come from a packet (dry powder), they are then mixed with liquid (milk in this case).
I would think enzymes would be also a powder, that would be mixed with mashed up food.
With the camera, I expect they would be looking for maybe an obstruction/abnormality/damage - as well as I would think they would probably take a small sample from the oesophagus and/or gut wall to look for the microscopic damage. Not sure how they work out any specific digestive enzymes deficiency though.
If I were you, I would try and read up on research (pubmed scientific papers, workings of digestion etc) to have a good understanding and ask drs in-depth questions.
Analyze/think through any symptoms in ds1 and you as parents, as some traits can be genetic and symptoms could be connected - although not necessarily the same (that's how it was with gluten for us, there was writing on the wall so to speak from family health complaints, but it came to the crescendo in my ds).

[alypaly]

too many laxatives can make the bowel really lazy and difficult to get back to normal. Baby really needs a scan to see if there is impacted faeces rather than gp just giving him laxatives.

constipation can make the poo mucousy and also something called steatorrhea. Is it fatty or mucousy. Try putting it in the toilet and see if it floats( sorry TMI). if it floats its fat and sometimes u can see grease on the surface

[mad4myboys]

next poo, i shall chuck down the loo and see! They really smell too. i dont mean like smelly poo, like stale nastyness.

Thanks so much for replying to me guys, thanks for taking me seriously. How do you both know so much?

ok, so trying to simplify, what are the basics i should ask when we go in? Next time we go in it isnt a consultant appt it is for admission for the tests but obviously we'd get to speak to him first. I have given him all the history, symptoms, how things affect him etc. I was worried in the past about things like a kink in the bowel or something but quite a few different doctors have said he doesnt have the symptoms of that. Its strange as his tummy has never been distended.

[alypaly]

mad4myboys ..i am a pharmacy dispenser 9since i was 15yrs old) and have been in medicine as a medical rep for 13 years aswell.i read lots of clinical papers and am probably a frustrated doctor. I also get frustrated at the level of expertise that some doctors have....and their degree of caring. I used to do lots of lectures to senoir docs and consultants over the years on lots of different products from heart drugs to dermatology,arthritis, gastro...so i had to know my stuff othewise i would have looked stupid during question time. Also i am genuinely really interested in medicine ..i would always say get a 2nd opinion though with any of my advice as i am not a qualified doctor....it just annoys me when people dont get the treatment they deserve

[mad4myboys]

thats interesting. I def trust this doctor, i just want to make sure nothing is missed this time

[alypaly]

now that you have said it is really smelly and stale it does sound more like steatorrhea.What colour is the poo?
tell them about the mucousy poo and the stale smell,and whether it floats or not , as that is significant to the doc.
if there is an alkaline problem..the only alkaline thing around is bile which is a by- product from liver. This is stored in the gall bladder and then released when food is ingested,especially fatty foods. if he is getting alkaline reflux ( how has this been confirmed)maybe the consultant needs to do liver function tests and scan the gall bladder. you dont have to put up with this ,you need to find the right specialist.

[alypaly]

ask the doc what the damage to the oesaphagus is, it is your right to know and ask him to explain it in laymans terms if he is too technical.