Re: Question re Fundoplication - Alison

[Guest guest]

Hi Alison,

A few of questions for thought.....

Has Charlie ever been on continuous feeds, instead of bolus feeds???

Sometimes the smaller amounts over the longer period of time can help reduce

reflux.

Has Charlie been tested for Delayed Gastric Emptying??? This might be part

of the problem, and a pyloroplasty (a small cut made across the pylorus

sphincter to aid in emptying) in conjunction with the fundoplication, might

help.

Has Charlie been sick recently?? Sometimes illness will make the pylorus

sphincter swell, and children that have never had a problem with emptying,

will have their emptying times drastically.

Have you tried a change in the type of formula you're using?? Dr H believes

that Pediasure increases gastric emptying time because of how it's

formulated. I think she usually recommends PeptaMin Jr?? She put on

EleCare, which is an elemental, pre-digested formula that only requires

to absorb instead of burning calories digesting.

The combination of a PPI (Prevacid, Prilosec, Nexium) in the AM or PM, and

an H2A (Zantac, Pepcid) at the opposite time, has seemed to work well for a

lot of our kids, included. Our GI also said that we could use both

in the AM or PM, but that they had to be given at least an hour apart. The

PPI first and the H2A second.

Even with all of this, is still having problems with reflux and

possible aspiration, and Dr H's recommendation was to place a GJ, so I think

you're on the right track there.

Another concern would be why your Dr is considering GHT under the age of 2?

Before the age of 2, growth is ruled by caloric intake, not GH, so wouldn't

it make more sense to correct Charlie's GI problems, make sure that he can

consume enough calories for maximum growth, and THEN begin GHT??? Just a

thought....

Hope this helps!!

Pat (g-ma to , RSS, 3 yrs old, 23.5# (10.7kg), 32.8 " (83.3cm),

G-Tube)