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My 11 year old has been burping food 20 times a day for 5 months!
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My 11 year old has been burping food 20 times a day for 5 months!

My daughter started burping up food after a party new years eve this year.. She is 11. She was a little prone to this prior to the party but it only happened once every few months.   Now she does this almost every time she eats. (20 times a day) She's had an endoscopy, motility test, gastric scan, ultrasound, and a gall bladder test. She has a small weakness at the base of her esophagus.   The gall bladder test (torture for 3 hours) was inconclusive they said because she moved too much.  She is on 40 mg of nexium 2 times a day, and a drug called Reglan.  She is not getting any better after a month.  In fact tonight she has added stomach pain and incredibly loud stomach gurgling followed by frightening burps to her symptoms.  Her pediatric gastroenterologist is suggesting it is psychosymatic.  I don't think so. She's missed over 30 days of school.  The talk of esophogeal cancer being caused by constant acid reflux is terrifying me! HELP!
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What were the results of the endoscopy?  If they were normal done with biopsies the risk would be minimal I would think but I'm not a Dr., just a mom like you but with too much reflux exp. with my kids, etc.

You must trust your instincts because I have seen oftentimes when all else fails they say "in the head" and only when it gets bad enough that they find a DX then they all say, OH YEAH you were right!

My 17yr old was on Prevacid for a few years and recently they found out it was all Gallbladder related and her GB was removed after a HIDA Scan showed only 4% function!!!!!!  Was that the test your little daughter had?  I am so sorry .. it is long and must have been hard for her to endure.

They thought my dd had IBS for a long time and blamed it all on that .. then one day the pain got so bad she landed in the ER and was in-patient for 8 days .. it took 5 days to find out the cause was Gallbladder.

Since that day in Jan of this year she has only needed prevacid once for a bad sour stomach but hey we all get that sometimes right?

Reglan is a VERY powerful drug ...........................could it be making the burps worse and the pain worse?  It has a very strong neurological based component to it I think .. I will look in the health pages drug list for you and post the side effects, etc.

The docs oftentimes don't tell you what Reglan is .. dont' get me wrong I'm not saying don't use it but it is a major league drug ..

I have the burps you describe when gallstone or kidney stones are acting up ..........and, btw, my dd did not have any stones at all .

cheryl
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Thanks, I am worried about the amount of nexium she is on too.  It wouldn't be so bad if the drugs were helping her symptoms but their not really.  The endoscopy was normal according to the dr.   The only test that showed a problem was the motility test but the dr said it was a small weakness.  The stomach gurgling, pain, and incredibly loud burps just started yesterday.  My daughter had the gall bladder scan too, and the test was unreadable because they said she moved too much.   I thought she was being pretty still.  If they needed her imobile they should have strapped her down I guess!  
Deb
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Here is the Reglan link:

http://www.healthcentral.com/acid-reflux/find-drug-1256-150.html

Have they done stool tests and a test to rule out H-Pylori?  Just some thoughts but again, I'm not a Dr ... stool would ck for parasites, bacterium, etc.

Not too familiar with Nexium dosing .. we use Prevacid ... Will your doc allow Gaviscon at all or mega Mylanta?

Cheryl

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I don't think she's had a stool test.  Would parasites cause burping of food?  I would think that would cause full blown vomiting.  She said tonight when her stomach was gurgling that she felt like something was moving around in her stomach.  This just started yesterday.  We are getting a second opinion at Lehigh valley hospital on the 28th of May.  I hate how long it takes to get into see these doctors!  Thanks for the link. Deb
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It was just a general question because everything seems to have been thoroughly done to date .... anything going on in the intestines I would think could travel upwards into not so classic symptoms.

C~
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My daughter has had a similar problem, and ever since she had an Upper GI she has not been able to hold down much food. She is regurgitating food into her mouth, and the MD's dont seem to be able to offer any suggestions as to why she was fine before the Upper GI and now since she drank that barium she cant seem to stop the regurgitation.  She is also on Protonix 2x a day 40mg, and also tried Carafate and Zantac, She has only been able to eat breads and today we tried Rice pasta, it seemed to hold in her stomach somewhat. My friend who is a Pharmacists said that sometimes Erythromycin is used to treat motility problems small doses 3 to 5 mg per kilo of weight. You might want to try that I am going to try get that for my daughter.  Hopefully she can hold it down. Let me know if you find out anything. I will also post if I find any more info
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Has the barium passed thru yet?  Make sure it passes out completely .. if it is still there it may be pressing up causing pressure as in reflux?

I've heard that eurthramycin works well .. look @ Gretchen's post ... her son is on it ... I'm going to send her a note to see if she can post to you.

Cheryl
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Yes we had her finally exray'd to see if all the Barium was gone and it was backed up on her so after a couple enemas and some laxatives it is gone, but she is still unable to consume a normal meal, yesterday we bought some of that Smart Water plain water with electrolytes just to keep her hydrated.  We are only able to keep breads in her and the Rice Pasta seemed to stay down but she is only eating a half cup of food at a time.  I am new to this site and I am not sure how to navigate around, how can I see Gretchen's post not sure how to do that?
Lisa
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It wouldn't be too easy ..... you can see her screename on the right hand side and that would alert you she answered somebody or created a post but you wn't be able to easily find it bcz this post was contained in another post I think as a reply so I am going on memory.

I just sent her a message for you :)

Cheryl
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I was told that anything that upsets the water balance within the intestines can be a sure fire indication that a reflux flare will follow.  This I was told when my son at age 12weeks had a bowel resection.  The Pedi GI was awaiting an awful reflux flare.

that would be my best guess as to what is happening right now as all has been disturbed with the barrium, etc. making symptoms so much more pronounced in the reflux dept. ????

You can try to add things to help weight down the liquid .. the water itself may actually create reflux as it is so light up and down ... but I understand it's tough not being able to drink anything else .......... stay away from milk too I would think.

Baby food in baby jars PUREE STAGE I is another thought I have for you to reintro solids at this difficult time

Cheryl
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Well she does not drink milk and that was stopped years ago, due to it being a major trigger for her reflux.  

I think you hit the nail on the head, the barium just has given her a major upset and flare up. We are trying at this point to just keep down carbs, breads, rice and then we will advance to some baby foods, someone else had suggested that to me too.  I am also going to try some Rice Milk if we get through this bad period. I just wonder how long will this flare up last?

I sent her back to school yesterday (she is 14 and also mentally challenged) for the first time in 2 weeks and she did regurg in school three times with mouthfuls, but she was able to make it through a whole day. I had the school nurse give her Maalox in school just to calm her esophagus and it seemed to settle her just a bit.  I am giving her Protonix 2x a day and I am going to start giving the second dose before dinner instead of before bedtime since it seems to have eased her pain in the LES.  

She did have an endoscope last thursday and she did have two stomach polyps, (which I have read can be caused from long term use of PPI's like Protonix etc.  We will be getting the pathology from those polyps next week.  

Note to Deb:  I would try stay away from the Reglan and try to do the Erythromycin, Reglan has major side effects. The Erythromycin used in this way is not commonly known and my friend who is a Pharmacist in a hospital suggested it.  Also I have been visiting a site called "healthline.cc" (not .com)  This guy has a radio show and is an expert nutritionists,(MD) He has some wonderful products that really help. and certifies MD's all over the country to administer his health products that attack every sort of ailment I am going to travel to see one of his practitioners for other issues and my daughters reflux issue.
Lisa
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You can also make your own pureed foods that may be tastier as you reintro .. one other thought is if you go with the rice milk (we know rice milk very well, here, too) is to ask your Dr. about a product called THICK IT and that will thicken it .. it is used for geriatric patients as a thickener.   Not for long term use as it may fill her up and less nutrients but may be worth a try if nothing else helps~!

SO SO glad to have helped!!!

Cheryl
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Thanks for the suggestion of erythromycin.   What does it do for reflux?  My doctor says the reglan actually strengthens the muscle to keep the food down.  The amount of food that she burps up has lessened but it is still happening enough to be sent home from school 2-3 days a week. She's been on the nexium/reglan combination for about a month now.
Deb
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The nexium may not stop it from coming up; but it should stop the acid from burning when it comes up.  Let me see if Gretchen is around to answer the other ? on how the med works .. my son was severely intolerant to caseine in milk ... so with him, he turned the corner at age 2.5 when he went onto rice milk and off alimentum under guidance of Pedi GI ..

Cheryl
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I don't know a ton about the "how", but here's an article I found that talks a little about both Reglan and Erthromycin. http://digestive.niddk.nih.gov/ddiseases/pubs/gastroparesis/index.htm.
Basically, I think they just make the stomach contract(not painfully) and it empties faster. Not to be to gross, but by emptying faster, I don't see an increase in poops or anything. The side effects of both Reglan and Erythro are N/V and stomach aches. Kind of weird, but I think they mean at bigger doses. Jarrett takes 2.5cc 3 times a day of liquid Reglan that's 5mg/5ml. On the Erthro, he took 2cc twice a day(I think). The funny thing is our local ped who's been a doc for 25 years didn't know anything about Erthro. We're in a smaller town and when I told him the dose, he said "That dose isn't going to help him with anything." I tried to explain to him it wasn't an antibiotic dose. He called the pharmacist so hopefully they explained it better. We just switched Jarrett back to him last year after getting all his care at a large facility. Some days I think he wants us to go back!!

Gretchen
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Can it be compared to taking antibiotics to thwart off ear infection; low dose for a few mos kind of thinking?

C~
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Another med that they tried to put my daughter on is Carafate, used for ulcers, it coats the stomach and eshophagus and can sometimes calm it down. In  the hospital they gave it to her in pill form but the Ped GI gave it to us in liquid form. by using the liquid form it calms the esophagus and stomach and coats it good.,in the pill form it only coats the stomach and not the esophagus, therefore the reason for the cocktail with Maalox and Carafate pill to coat both. I found that she was able to keep down the Carafate pill and not the liquid. So I might go back to that today if all else fails.  I think also I am going to try probiotics too.  

We are on the cusp right now and they said that if I dont get her eating they are going to put her in the hosp but God willing we are going to get better today!
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Please keep us posted.  Yes, I think Carafate is a wonderful drug and with the Mylanta is even better .... for anybody reading this .. be sure your Dr. has given you the script PLUS be sure the med MUST be spaced out from the reflux meds or the reflux meds will not absorb and work properly.

Let us know .. I'm thinking of you and the probiotics .. I am with you 100% .. I go there, too, as a last resort ... others use them all the time!

C~
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Spoke to MD and they said that all of the pathology from the endoscopy came back normal!!  Praise God!  So far today she has not regurgitated,,,, another blessing! If we get through the evening meal I would say that we are on the road back.!

I read on a couple of websites some of the more serious side effects from barium are back pain, and prolonged cramps, which she had, as well as complications to existing illnesses. Tou che Cheryl!

Anyways, today has so far been a good day!  I would like to thank this forum for giving me ideas and comfort!

Deb, I hope and pray that you get some sort of answers, being in the dark is the worst feeling. I just thank God every minute for people to share my woes with.

Cheryl, thanks for trying to help so many of us! you are an inspiration. Your insight and genuine concern are uplifting!  I will keep you posted later about how we do tonight!
Lisa
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My turn tomorrow.  My 10yr old sees the pedi GI .. for constipation and stomach cramping issues ... as a toddler she had anal fissures .. all went away along with the constipation and now 8yrs later it is back and for some very bizarre reason DayQuil is the only thing that helps ... I give it sparingly at night when the cramps are bad .. it is sudafed type product, cough med + tylenol .... I will be sure to tell the Pedi GI this tomorrow.  She was getting reflux, too, when it was bad from being pushed up .. but a Fleet Enema at Ped's advice took care of that problem only now still having the bad cramps ... Miralax is helping the stool but not whatever the problem is.

Thank you so much for your kind words.  Whoever you know send them over.  I find reward in helping others ..... as others have helped me along the same path many yrs ago.

This is encouraging with your daughter!!!!  I hope she gets better and better as the days go by .. watching our little ones suffer is so hard .. it isn't in the textbook.

Cheryl
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Maybe you could ask your ped GI if they have ever heard of anyone reacting to barium like what happened to my daughter sometimes you come across other areas where someone has heard of other things and how they dealt with it.  

Anyways my daughter regurg'd 4x but I think I found out what the trigger is,,,,,, if you can believe it,   drinking! She hadn't drank any water all day until around 4:30, then she refluxed 4 times in a row.  It happened the same way yesterday, she was fine until she drank the rice milk.  Well at least that is my thought.  But we are still doing better than yesterday. Anyhow, I am not sure what the rest of the night is going to bring, but I am holding out hope!  TTYL
Lisa
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Have either one of your kids been tested for Celiac (gluten-wheat allergy) That does cause a whole lot of intestinal problems. It runs in my family and two of my sisters have it.  Deb that might be an idea for you too since, reflux is also a side symptom for celiac disease. It definately causes abdominal cramps too.  Sometimes during endoscopy they test for that when they take biopsies of the stomach. Or some other food allergies sometimes can wreak havoc on kids digestive systems like lactose or there is a test that they do for stomach allergies but I think that it is done froma biopsy of stomach tissue.  We had a descent night and no more regurg for today! Blessing to all until tomorrow!
Lisa
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We've avoided biopsies to date and the ones tested via blood for makers were ok ..... came close with my 17yr old in january but they feel the inflamamtion they saw on the CT Scan was viral .. whew .. it was close to scoping time for her.

On the water / rice milk being a trigger it is the consistency being so thin that may be the problem.  Wonder if something thicker would work better .. they have a product called thick it the GI's can order to add to help wt. things down.

Just think 10yrs ago this was all new for the specialists and today they are all recognizing our kids have issues!

Cheryl
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Thanks for all the good wishes!  One of the frustrating things about my daughter's illness is that it can be triggored (not the original cause) by stress.  If she gets upset, she burps up food.  If she eats too much she burps up food.  Once one of these things happen she then continues to get sick repeatedly after eating, no matter what she eats.  We are at our wits end. She missed school today because she remembered she had a spelling test as she went out the door for school and started bringing back breakfast.  So then of course nothing stayed down all day after that.  It then usually takes a day or two to get back under control until something else stresses her or she eats something fatty, or too much of something.  Then it all starts again.
Deb
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I wonder what chemically causes that to happen or physically .... I'd be interested to know .. I know stress can cause the gasttric juices to start churning .. as well as chewing gum, etc. and too much calcium in tums type product can be counterproductive to reflux, too, but really not sure on the element of stress itself causing the muscles to relax ... there must be a reason why .. wonder if the Dr. on the adult Reflux forum would know . ?  

May be worth posting there?

http://www.medhelp.org/forums/show/200

Cheryl
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Stress is definately a trigger for refluxing because you start to produce more gastric juice.  Also  you might want to start modifying what she eats.  Milk can be for some kids another major trigger for reflux. Are you regularly using the Reglan?.  We are going to try it over the weekend. I am scared stiff to try it, but we too are at our wits end. My neighbor phamacist/mom said she called our Childrens hospital to see how they give it it and they actually give it to infants with reflux so I guess the benefits outweigh the side effects. Our nurse practitioner said that the jitters is the biggest side effect for kids and they rarely see it. I am still leary of it, but I guess we have to try!

Jenna is still regurgitating, even after decreasing the amount liquid that she drinks. It seems as though nothing is going to stop it.  My neice's boyfriend is an ER MD and he was telling her that there is some kind of physical therapy/occupational therapy out there that helps people control that esophogal muscle. I am going to look into that more over the weekend. I will let you know what I find out.  

Deb how did you daughter do on the reglan and how are you dosing that?

Cheryl, How did everthing go at the GI MD today?

Lisa
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Thanks for asking .. b4 I get to me .. I agree it is time to try the Reglan .. she cannot go on like this .. no way!

See post above entitled 10yr old daughter at Pedi GI .. it was a great first-rate appt for certain .............now I get to collect poopsicles .... well, not frozen this time LOL, but 3 separate days worth to be certain nothing is missed in the process .. ugh ugh and ugh again .. last time I did that with my 17yr old I got sick and contaminated the specimen .. ROTFLOL!

C~
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My daughter had 8yrs of speech therapy and 2 yrs of therapy for bilateral vocal cord polyps that turned out to be aggravated by UNDIAGNOSED reflux that she had for yrs and she never felt because it never came up high enough !!!!!  The therapy she rec'd was different, though, from what you are talking about .. they even have sensory integration type of therapy along with swallowing therapies, etc., etc.

C~
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Yes that's it swallowing therapy,,,, did you get that and do you know what that is?
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Did your son get sick on the reglan?
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My son didn't get it but probably *should* have gotten it .. he was borderline senosry integration problems with the reflux with high startle reflexes and things bothered him along with extreme mommy attachment which didn't allow him to go to preschool until he was 4.5 (and he was my 4th child so you can imagine how hard that was for me LOL) ..

My son would cry from the reflux pain and vomit.  And then cry when he left my side if only for a moment and vomit and vomit and vomit!  The vomiting came from the weak muslce of the stomach and the reflux .. it was an awfully visious cycle .. he'd get frustrated as a toddler or if I said he couldn't get a toy in the store and vomit ...

I know this is a sidetrack but I forgot about this with him!

Back to the swallow study:  he didn't get it but wouldn't eat hard, crunchy foods .. what they do as I understand is they take a washcloth and rub inside the mouth on the tongue and cheeks to help in that regard.

What they do for the therapy for swallowing I'm not sure .. but I know he couldn't drink fruit juice for 4 yrs or drink from a straw .. both brought on reflux (suckling the air) and the fruit caused pain.

TMI (like the teens texting:  too much info I know) .. but all came flooding back with your one line post to me LOL!

If they offer the OT go for it is my opinion.  I had to push.

And my son had 2 yrs of speech .. sometimes the muscles don't form right in the mouth from not eating solid foods until later with some refluxers.  That happened with 2 of my children .. one was 80% uninteligible and her speech was 8ys with 100% success and my son was 2yrs @ 40% unintelliglbe and his was 100% success, too.

Also watch for development milestones to be certain all is on track.

C~
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Kristen is taking 4ml of reglan 30 minutes before each meal and right before bed so 4 times a day.   We have not seen any side effects as of yet.   She has been on it for over a month, we've seen a decrease in the amount of food/fluid that comes back up but she is definitely not cured.  She still misses about 2 days of school a week.

My question to anyone who has used Reglan with their child is this.  Is it suppose to "fix" this?  My expectation is that it would stop her problem.  Yes it is a little better, but definitely not cured.  How long until I have a child who can go to school?

Deb
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Reglan is a dopamine which means it works on those receptors, it is suppose to help with moving food faster out of the stomach (motility) and strengthing the Lower esophegal sphincter (LES), It is meant to help but not to cure. I would lthink that you need to make major adjustments in your daughters diet. Bland ,,,, Bland ,,,,, Bland and small amounts of food start with on half to three quarters of a cup of food at a time,  and no juices or fruits right now unless the fruits are cooked, I would even hold off of fruits all together until you see some improvement.  I would also stay away from raw veggies and salads.  No fats or oils. You need to make drastic changes in diet to calm her system down first. Use whole grain breads and no spices, I have seen alot of success with my daughter with whole grain English Muffins because they are heavier and stay down, with a little smear of fruit spread.   Not alot of drinking with meals since it creates volume in the stomach and is more likely to be pushed up. YOu also may want to consider stoping all dairy and eggs for now.  We are also eating Barilla Plus pasta a high protein pasta, last night for dinner we did a plain turkey sandwich the first protein she was able to keep down in TWO WEEKS!  It is going to take some time. Also make sure you are timing the meds properly, and I would try some Maalox to calm and coat the esophagus when she starts and episode of regurg.

A friend of mine was telling me about kinseology and how that helped her with a host of digestive problems and food allergies. A type of chiropractic care. Not cracking! I am going to go for that as well.  My main concern now is getting through the end of school too!  She has missed two weeks in a row!


So here is my strategy for now, keep advancing diet slowly, try the Reglan, find out more about the swallowing therapy and the eating therapy, as well as the Chiropractic kinseology and somehow someway with the Grace of God and His will we will get better!

We are going to start  the Reglan today, wish us luck! We are going to try it before lunch and see how it works. I will post later and let you know how it works.
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Hi.  Good luck starting the Reglan.  My daughter really has not had any side effects so far.  I was researching her symptoms last night and found something called rumination disorder.  Kristen seems to fit into what they are describing.  I am going to see if the deep belly breathing they use in treatment does something for her along with the meds.
Deb
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Well on top of everything else that has been going on Jenna has come down with strep throat.  I Just hope the antibiotic doesnt upset her stomach more.  
Lisa
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OH NO on the throat!!!!  And, yes, the antibiotic can do a # on her .. I hope it is the most mild one available for her right now that will help her get over that throat but not upset her tummy!  I feel so bad for you ... oh no!!!!!

Cheryl
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She started 2000mg of Penicillan and of course, there are only certain scripts you can use for Strep and penicillan is the first line.  We will have to go with it I guess.   Bad day for regurg, for some reason,  Yesterday we were regurg free! Today we are making up for it.  The Pediatrician wants her to go to a swallowing clinic. I hope we get into the other GI specialist soon!  THe only thing I have to say at this point is Why?  I guess we all have that question about our kids.
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Last I heard, severe reflux may be linked to a gene .. I will try to find out if this is accurate info or not but worth asking about.  

I wonder if she has had the strep long before she had symptoms and that is accounting for all going on in addition to the barium ? hmmmmmmm ?

My oldest had what is called post streptococcal reactive arthritis at age 10 from a strep infection that was undiagnosed or missed on a strep culture .. it produced an awful arthritis similar to Rheumatic Fever but slightly different and it was verified thru a high level AntiDNase-B blood test for it ...... moral to story:  strep is nasty germ and can do nasty things as you probalby are aware and that germ alone can cause a bad reflux flare and/or stomach issues in an otherwise healthy kid .....

What a roller coaster you are on .............

C~
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I am considering at this point to take her to the Mayo Clinic. They are suppose to be the experts  in Gastrointestinal Diseases. In the mean time I am going to get her into the swallowing clinic at our Childrens Hosp and see what they say. I am so confused and bewildered.
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I am researching a disorder called rumination.   I think my daughter has it possibly.  The Mayo clinic did alot of studies on this too.  It reccomends deep breathing exercises for children who are burping up food repeatedly.  Kristen has been trying it and it is making a difference.  Imagine after 6 months of tests and missed school, tons of meds all she needs is deep belly breathing.  I am hopeful!
Deb
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WOW .. Do you think she has been swalloing air?  My Ped GI was concerned that my dd may have been drinking thru straws alot .. that can cause gas; in her case it isn't the case, but interesting to note straws and gas, too.

WOW again!

Cheryl
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I am not sure if swallowing air is causing it, but she has always been a fast eater. Along with slowing her down, we are trying the deep belly breathing when she feels like she is about to get sick.  The idea is that the two actions are not possible together so the breathing in and filling her belly with air does not allow her to do the action that brings the food back into her mouth.  It is still to early to tell if it is her "cure:" but it is helping over the past two days.  We are staying on all the meds for now obviously, but I'd love to get her off them eventually, especially the reglan.
Deb
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I know what you mean with the meds .. getting off them .. sometimes I wonder if they cause some of the problems but that is stretching it a bit .. but as  mom, that is what I oftentimes wonder about myself inside ??

When I had root canal done and almost threw up one time the Endodontist told me to raise my feet up as I was lying in the chair and it worked .. I did not get sick to my stomach and it went away .. your post reminded me of that time in the office chair!

What our poor kids have to endure.  Makes me so so sad.

C~
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Well I have some good news to report, we had a regurg free day yesterday, we tried chewing gum. After our evening meal seemed to be the worst time and I saw this on the teens reflux website!  Deb I think Jenna might have had rumination as well but the involuntary kind.  I guess the theory about the gum chewing is that  it activates swallowing more often and might triggor the LES to close so that stuff doesn't come up,  we are going to try the deep belly breathing, too! Do you have a good website for showing technique?  Cheryl that is interesting about raising your feet up, I wonder what that triggers? Hey maybe we are on to something!  Deb I am so glad that you found something that is helping, I was just reading about the deep belly breathing yesterday. I want to try it with Jenna. Keep me posted!
Lisa
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You know my teen (17) swears that chewing gum helps to settle her stomach ?????  .. we had a round-robin with me disagreeing that it churns the gastric juices ......

Hmmmmmmmmmmmm .... but never admit you wrong to a teen ROTFLOL!

C~
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I used to think the same thing, but if you take it after a meal I think that makes the difference, when you chew it on an empty stomach I think it definately makes you hungrier!  but I have seen it used as a coping mechanism on two or three websites!  
I'm with you on the admitting part!!!!!! ROTFL!
Lisa
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