How to diagnose GERD or EOE in my child?

Question

Hello doctor,

My 11-year-old daughter has been struggling with persistent nausea and occasional vomiting after meals. She also complains of a burning sensation in her chest, and we have noticed she has become hesitant to eat. Despite trying dietary changes, her symptoms are not improving. I am worried, this could be gastroesophageal reflux disease (GERD) or even eosinophilic esophagitis. What would be the most child-friendly approach to diagnose and manage these symptoms?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Regarding gastroesophageal reflux disease (GERD), esophageal pH monitoring (study of the amount and stay of the duration of stomach contents in the distal esophagus) is the test used to confirm the disease, another important test is upper gastrointestinal endoscopy with biopsy for severity and complication of the disease (endoscopy with biopsy is also used to confirm eosinophilic esophagitis). Other than these tests are only supportive and do not confirm or rule out the disease.

I advise you to do the following things. These include:

Head elevation during sleep.
Frequent small-portion meals.
Reducing weight, if overweight.
Avoidance of smoking, heavy fatty meal, and late-night meal.
Prokinetic medicines to be taken (which enhance the gut motility).
Antacid medicines to be taken.

Some old studies used to give antacids trial medication as a tool for diagnosis of GERD ( if symptoms disappeared with antacid medicines, it indicated that the patient has GERD and if not, another diagnosis should be looked for. That may be eosinophilic esophagitis) but this study is obsolete nowadays because of many false positives results.

Kindly consult a specialist doctor, talk with them, and take medications with their consent.

I hope this helps.

Thank you.