Reflux in older child

[Catlady724]

My dd is 11 and has had reflux issues all her life I think, undiagnosed for a long time. For a few years now she’s been on prescribed Gaviscon which doesn’t really help. The Gaviscon just comes back up with the reflux. We’ve now tried a course of Omeprazole and Lansoprazole - neither have helped.

The reflux seems to happen regardless of what she eats and she says it’s actual food being regurgitated usually. Her weight is on the low side, but always has been.

The GP seems a bit stumped now and is going to refer to gastro… I just wondered if anyone has been through this and has any advice / ideas on what might happen next?

My daughter is a similar age and is becoming increasingly prone to reflux. I think it may be linked to hypermobility/EDS in her case, possibly the muscles are too lax and not keeping food in the right place.

Worth considering it if your daughter has any other signs of hypermobility.

My DD is same age and started this too. Those medications need up to 3 months to really make a difference, so worth persisting.
Did you change diet at all? Low acid etc? Again it's not an instant fix. My DDS biggest change was from going gluten free. She's not coeliac (tested) but I think it was just tough for her to digest.

Any chance she's constipated and "backed up"?

My DD got tested for h. Pylori, and did a barium swallow test - swallow a liquid and then get x-rays while standing, lying and swallowing. It's shown no reflux in the end but did show other issues. We ended up going private because nhs was very slow and she was in such a bad way - in bed all day with sick basin, and obviously missing school, had to drop out of her clubs.

My son had problems with food swallowing and regurgitation, tremendous acid cough in the night, during Covid he was dismissed as anxious, he ended up constantly regurgitating food and water at the end and I began to panic ,his weight dropped too far and the paeds just said it’s anxiety, I pleaded with him for further tests , we ended up with barium swallow ,which showed a narrowing and expanded oesophagus in places. After an endoscopy was performed I was told it was achalasia, the muscle entrance to stomach wasn’t working well and stayed shut for long periods. It was stretched and he began to eat and gain weight .

Any history of food allergies by any chance? DD, same age as yours, was allergic to dairy and seemingly grew out of it at about age 6.

Few years later, the reflux emerged, and the GP said it was not likely to be food-related "and just sometimes happens at this age". Prescribed omeprazole but just never fully solved the problem and the dose kept increasing.

Decided to eliminate dairy for 6 months, just to see, and it WAS the culprit. She's been off omeprazole for about a year now and is dairy-free.

I had this issue when I was a teenager and an endoscopy showed a hiatus hernia. I also had a patient and without going into detail, all of the doctors and their parents thought they were doing it deliberately and it was an eating disorder. I spoke to them and my gut said otherwise so I asked the doctor to refer them for an urgent endoscopy. It turned out they had achalasia.

Possible hiatal hernia

Dd was like this , ended up being in alot of abdominal pain and constantly nauseous, and tired. She was seen by peads who were going to do a ph test and barium swallow. By the time this was arranged ( during covid) she had gone gluten free and was completely normal. Gluten exposure now makes her ill but we cant test for coeliac as she is now gluten free. Ask for a coeliac screen if not done , but make.sure shenstays on gluten till it is.

My nearly 11 year old son was diagnosed at 6 but we suspect it's always been there. He started with Peptac, then Gaviscon Advance. Most of the time, it keeps the acid down. GP isn't interested, just keeps prescribing.
There is a really good Facebook group for parents of children with reflux.
If you get the chance to see a consultant gastroenterologist, go.
Good luck and hope she gets the help she deserves.

Is it definitely reflux (as in - it tastes acidic/like vomit)? Another cause could be rumination if it’s not acidic and actual food.

Achalasia isn’t very well known , it can easily be misdiagnosed as many other gastro issues. It was only when his symptoms matched those I had seen on a fb group,mainly the crippling chest spasms.

Look into rumination syndrome if the symptoms fit (regurgitation of food contents rather than acid/vomit frequently). Unfortunately there isn’t an easily medical treatment for it, but diaphragmatic breathing exercises can help.

My daughter is nearly 5 and has had reflux since birth. She's on omperazole and domperidone for the reflux and still has infant gaviscon to thicken liquids in the evening.
The omperazole only works at the highest doses for her age. She was put on 20mg twice a day at 3 but had to see a gastro specialist to get this dose her regular paediatrician was following highest dose for her weight which wasn't sufficient to manage her symptoms.
When her reflux is uncontrolled she gets regurgitation symptoms too, so they think she brings up food and liquids due to reflux but then her stomach continues to regurgitate afterwards out of habit.
She has a lot of food allergies and these can contribute to her reflux symptoms. We also have to be very careful with her teeth as she has acid damage. She gets fluoride paste put on her molars every 3 months for extra protection.

Have they done a gastroscopy to have a look at her reflux and see if there is ulcers there too?

I have a DS the same age and wondered the same about hypermobility. He has been on Omeprazole for years now and it helps, but not always. He still sometimes gets symptoms of reflux (acidic taste, burning, pain) and also occasionally gets terrible breathe which is unrelated to oral hygiene- it seems to be coming from further down!

The GP was pretty dismissive when I queried whether it could be related to hypermobility as DS does not score highly enough on the Beighton (?) scale. Eg, his fingers bend back flat against the back of his hand, his thumb joint is very unstable and dislocates easily, but he can’t touch it to his arm, so the GP said it’s not hypermobility.

Still, I can’t help wondering the same as you!

Sorry to jump on this. Can I ask if your daughter’s sickness started suddenly? My 5yo DS has been sick & awful stomach pain everyday for 2 weeks and hospital have given us omeprazole as suspect it is reflux. He has never had any issues before. Did you go private for H Pylori test? He still has a bit of pain at the end of the day but the sickness seems to have stopped. They’ve only given a 14 day course & I’m terrified what is going to happen once this runs out.

@mamah2020 it was done in second nhs gp appointment. It needs to be done without any ppi in the system as it can give false results.

My dds stomach pain was more from being sick than an initial symptom.