Hi,

I was just wondering if anyone could offer any advice about my 21 month old as I am a bit confused about his symptoms and whether they are related or not.

My DS suffered from quite bad (very visible) reflux as a baby and has severe multiple food allergies.
He stopped spilling between around 12-13 months old, however since then it still sounds as though he is refluxing... ie many times a day he makes loud gulpy noises with a kind of 'rising liquid' sound to them (if that makes sense- not really sure how to describe the sound) then occasionaly he briefly coughs and chokes afterward. Sometimes after making this sound he cries, sometimes grimaces and other times just carries on as if nothing has happened.
Should we be looking at re-medicating him? (he was on omeprazole as a baby but gp reccomended we stop when he was around 5 months as it did not seem to be making any difference at all)

Secondly, pretty much all winter he has been waking fairly often during the night with noisy 'wet' sounding breathing, and kind of panting through his mouth as though he has been running. I kept thinking he was getting sick, but then he was always fine during the day time. Could this be reflux related from lying down? (his mattress is raised at head end)Or something else? (dustmites or early asthma symptoms or something?)

And thirdly, he has suddenly developed an unusual cough. He will be fine, then suddenly randomly have a big coughing fit where he is gasping for air and choking and retching. Then he cries because it has scared him (hurt him?) and of course that then makes the coughing much worse.

So, any words of wisdom/ideas on any of the above would be appreciated Thanks

I'm afraid that very much sounds like reflux symptoms to me.

The gulps, 'wet' breathing at night and particularly the coughing fits all line up in my experience.

Omeprazole might make more of a difference now he's older and weight gains aren't so large and frequent and so it's easier to keep it in a useful dose range.

There are two options now - losec which you'll have to pay for, or Dr Reddy's which is fully funded.
Some people, esp those with more senstive children and particularly babies seem to have a few problems with the Dr Reddy's and find they have to pay for the Losec to get the relief they need. Others are fine with the Dr Reddy's. I'd probably try the Dr Reddy's first, esp since the Losec didn't help much when he was a baby so a slightly different mix might help, but bear in mind you may need to change to the Losec.

They are the same drug just with different inactive ingredients.

Failing that - since he has an allergy component - you might want to think about ranitidine (Zantac). It has a slightly different action to suppressing acid production but also has a slight antihistamine effect so might help along the way anyway.

Thanks so much for your reply Eleanor.

With the losec/dr reddys- when he was initially on it we started with losec for maybe a month or so, then were caught up in the change over and were switched to dr reddys. To be honest we didnt think either of them made any difference to him at all at the time (although now I think about it, actually that is not entirely true as after starting on the losec the the blood specks in his vomit stopped, but there seemed to be no change in pain or behaviour), but as you say things might be different now he is older (and also both were given as suspension which could also have been why they didnt work).

Ranitidine sounds good though if it also has an antihistamine effect. That would probably be ideal for him. (but Ive heard it tastes foul? He is not good with bad tasting medicines )

But I guess my next question is, how neccesary is medication for his current symptoms in my first post? I would prefer not to medicate if possible, but have also read lots of nasty scary things about oesophageal damage if left untreated. And how common is it for children to still be having issues at nearly 2 years old? Is it likely now that he may not outgrow it?

Hopefully we will see our paed again soon so I can ask him about it. We were supposed to be seeing him this month but I have heard that apparantly with all the winter bugs around at the moment all the appointments are running at least 3 months late. Should I be pushing to see him sooner?

Thanks again

Ranitidine has a very strong mint taste - some like it, others hate it - so whether he likes it or not depends on the child really. It's not particularly nice but def not as horrible as the omeprazole suspension - that really is foul!

How necessary is medication? That's a hard one to answer - and one which needs to be directed to your paed if that's where you are getting your on-going care.

As for growing out of it - every kid is different but I know our paed was talking surgery by the time Thomas was over 2 and we couldn't get him off medication. My older two were off meds around 2 1/2 but in hindsight shouldn't have been - both went back on by 4 1/2 - 5 yrs old.

The only way to tell what damage is being done without medicating is through a gastroscope with biopsies and that's not a fun experience.
But if you aren't reducing the acid washing up then the odds are pretty good that so kind of damage will be being done - the lining of the oesophagus isn't designed to be bathed in acid.

Despite medication Thomas had an ulcerated oesophagus acc to the surgeon when he got in there, Nicholas apparently had some adhesions due to acid exposure and William had an oesophagus which had shortened due to long term acid exposure as well as it having adhered to his diaphram and stomach - all on meds.

So I'd push to see your paed sooner to get an opinion on what to do longer term.

On the Ranitidine side of things, my James hated it and would spit it out. Will would happily take it though. I wonder if there's a degree associating the taking with feeling better? So you may find it's sucked down before long.

Good luck with appointments!