child with Barrett's esophagus

[Karen__0]

  :
  : I posted this in the gastroenterology forum, and was told to post it here..
  : My son was diagnosed with Barrett's when he was 9 yrs. old, he's 13
  : now. He's been taking Prilosec ( 20mg) for the past 2 years. Prior
  : to that he was taking Pepcid. He's doing good with the medication. My question is: Is there a possiblity
  : that prolonged usuage of this drug will cause any other problems.
  : And also how common is Barrett's in children and the outcome in the
  : future. He's been told he'll need to take med's for the rest of
  : his life. Any help would be appreciated.
  Dear karen :
  We apologize for the delay , but we have been trying to identify the incidence of Barret's esophagus in children . Since you have reposted your question , we shall be answering the prilosec side effects and hoping to continue our research on the incidence of Barret's in children.
  Barret's esophagus is uncommon in children and usually presents in middle aged white males ( male:female ratio=3-5:1) . It arises as a complication of gastroesophageal reflux , the incidence being about 8-10% of people with GERD , and has been noted that the risk of developing it increases if the exposure of the esophageal mucous membrane lining to the gastric acid is more than 5% of the day. It can also be a sequale of esophageal injury , bile reflux or pancreatic juice reflux into the esophagus .
  There has been no evidence that once the Barret's esophagus is established , that it would ever regress to any degree inspite of intensive medical or surgical therapy , therefore life long therapy is indicated.
  It's management is basically to reduce the exposure of the esophagus to the stomach acid , Prilosec being an acid pump inhibitor , is generally well tolerated , short term side effects including headache , diarrhea , stomach aches , nausea , constipation , back pain , cough and rash . It's fairly a new drug and there is not much in literature regarding it's prolonged use . Updates will be posted on any new releases .
  Thank you
  L.M.
  Disclaimer: this information is for academic purposes only.
  Keywords : Barret's esophagus*, GERD*( gastroenterology)

[HFHS.RN-AM]

Dear Karen,
We presented your question to our Pediatric Surgeon. He commented that Barrett’s esophagitis can only be confirmed by biopsy and hopes that your child is being followed by a gastroenterologist as well as a pediatric surgeon. In cases of confirmed Barrett’s esophagitis, a fundoplication should be performed. This is a surgical procedure in which the upper end of the stomach is wrapped around the esophagus and sutured in the front, creating an acute angle to prevent the reflux of acid into the esophagus. This procedure carries a high rate of success and is easily performed in an hour or less.  If you require a referral to a pediatric surgeon, I would encourage you to discuss this with your child’s pediatrician first as this information is provided for academic purposes only.
HFHS.RN-AM