|Apr 09, 2015|
9 year old with Barrett's EsophagusMy nine year old daughter (former 32 week preemie twin) has suffered from GERD since infancy. She has been on and off PPIs her whole life. This most recent episode started last June. She wasn't feeling well, threw up a few times, and it must have exacerbated her underlying reflux. So she went back on meds. Ranitidine 150mg didn't work. Omeprazole 20mg didn't work. So we went back to a GI we had seen a few years ago, and he put her on a pretty hefty dose (30mg) of lansoprazole. It seemed to help a little. She was on it for a couple of months then, in October, at the start of RSV/flu season, we tried weaning down to 15mg. (Didn't want to rob her body of it's natural defenses against illnesses during the winter months, in part because she is also asthmatic.) She did NOT respond well to the wean and seemed worse than ever. So we put her back up to 30mg but it still wasn't working. So we went back to the GI and he decided to do an upper endoscopy. The biopsies showed that she has lactase deficient (level was 11.8), and also showed focal areas of intestinal metaplasia in the GE junction. So they diagnosed Barrett's, said to start a lactose-free diet, and switched her to pantoprazole 40mg. It's been six days since the change in meds and she says she feels either the same or slightly worse. We have a follow up appointment in a May and he said he will probably scope her again in the fall.
My questions are about long term PPI therapy and whether or not it is a good idea based on the potentials of brittle bones, chronic gastric irritation and B12 deficiency.
And also, and perhaps more so, I'm wondering if a Nissen will be suggested. I've heard Nissen horror stories and some people seem so anti surgical options. I just want to gather as much information as possible so that we can weigh all of our options.
Would appreciate any information/experience you have! Thanks
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