Constant vomiting for 2 year old

[AliciaClaussen]

Hello. My friends child is a 2 year old girl. She had a bad start from birth, born without an anus and her asophagus wasn't attached to her stomach. Immediately a surgery was performed for the asophagus. After several months of having a colostomy bag attached to her, she finally had surgery for the anus. After she was dialated and seemed to be all good (for a couple of months anyway) she started vomiting a lot. The vomiting is more like a "spit up" of a brown substance that just sort of oozes out of her mouth approximately every 5 to 10 minutes. This can go on for days or just hours. Every once in a while during these episodes she will projectile vomit, ridding her stomach of all its contents but still continues to do the "spitting up". It doesn't seem as though a certain food or liquid triggers it, it just happens. Sometimes she will be OK on milk, sometimes it will cause her to start vomiting for days; same with juice, water, sprite, fruit, meat, vegetable, crackers, etc. No one type of food or drink starts it at all. Anyway, a few months ago she had a surgery where the doctors stretched her stomach muscle as they indicated that it wasn't working right in the way of digesting food. That was successful for about a month but now she is back to vomiting to the point of severe dehydration. I wanted your medical advise/opinion as I believe that there is something else going on and I believe that there is more to it then what she has been diagnosed with. Please let me know if you can offer any verbal assistance. Thank you!

[Thane A Blinman, MD, FAAP]

What you describe sounds like gastroesophageal reflux disease....possibly complicated by esophagitis, a stricture, or poor motility.  All of these are very common in patients with tracheo-esophageal fistula....but they can be managed!  

If she is suffering to the point of dehydration and very poor weight gain, she needs to be seen.  A pediatric surgeon or good pediatric gastroenterologist can arrange the right tests to tell which problem is the main one, and start fixing it.