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Reflux and Allergies

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Question

My daughter's reflux has been effectively treated with Prilosec until recently. She began to experience more discomfort and pain and an endoscopy revealed that the gastric acid was moving farther up her esophagus. The doctor is now recommending surgery. Our family recently moved and this necessitated a change in schools. Her allergies have subsequently gotten worse. Is there any relationship between allergies, and reflux? Or to stress related to major life changes?

Answer of our experts

Allergies can aggravate GER as can stress. There is something called eosinophilic esophagitis, which is poorly understood, can be very hard to tell from GER, and can be associated with allergy or can respond to elemental diet (e.g., removing all milk products). You could ask her GI doctor if the diagnosis was compatible with that. They could also try adding a drug like Reglan or Carafate to help. Prevacid is also supposed to be coming out with a liquid and SL form that should have more predictable bioavailable form (not a capsule form made up to a liquid.) That may work better. Sometimes adding nighttime H2 blocker such as Zantac will help. The approach depends on how severe the biopsy findings are

CP/TK 7-13-10

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Recommendation(s)

Reflux

R32
Consider always gastro-oesophageal reflux disease (GORD) in any individual with CdLS owing to its frequency and wide variability in presentation, which includes challenging behaviour.
R33
Modification of nutrition and proton pump inhibitors (PPI) are the first-line treatments of GORD. Anti-reflux medications need to be used to their maximum dosage. Surgical interventions for GORD should be limited to those individuals with CdLS in whom nutritional and medical treatments have been unsuccessful or airway safety is at risk.
R34
If GORD symptoms persist, endoscopy should be strongly considered whilst an individual with CdLS is still in paediatric care.
R35
Surveillance for Barrett’s Oesophagus needs to be discussed with and decided together with the family, balancing the potential gain in health and burden for the individual with CdLS.

Recommendation(s)

Paediatric Medical Care

R32
Consider always gastro-oesophageal reflux disease (GORD) in any individual with CdLS owing to its frequency and wide variability in presentation, which includes challenging behaviour.
R33
Modification of nutrition and proton pump inhibitors (PPI) are the first-line treatments of GORD. Anti-reflux medications need to be used to their maximum dosage. Surgical interventions for GORD should be limited to those individuals with CdLS in whom nutritional and medical treatments have been unsuccessful or airway safety is at risk.
R34
If GORD symptoms persist, endoscopy should be strongly considered whilst an individual with CdLS is still in paediatric care.
R35
Surveillance for Barrett’s Oesophagus needs to be discussed with and decided together with the family, balancing the potential gain in health and burden for the individual with CdLS.

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