GERD, delayed gastric empyting 3 year old

[Guest guest]

I have a 3 year old patient who has suffered from GERD from birth. He

nursed for 8 weeks before being switched to formula for FTT, and the

change did not help much. At 4.5 months he started spitting up blood,

at which point the pediatrician started ranitidine, which allowed him

to sleep through the night for the first time in his life. He is now

on lansoprazole and famotidine, 60 mg and 15 mg respectively. He has

had 3 gastric emptying tests, all showing severely delayed gastric

emptying - the latest test being 32% in 90 minutes. He has had two

endoscopy procedures with balloon dilation of the pyloric sphincter

with no success. U/S's have shown no abnormalities. The parents were

told then next bout of symptoms will mean balloon dilation with botox

or a pyloroplasty.

any suggestions on approaching this case?

Thank you in advance!

Sara Kinnon, ND

West Vancouver, BC