posted 08-26-2003 01:40 AM            

My otherwise healthy 3 yo son began having problems one year ago. After over a year of NO ILLNESSES...not even a cold or flu, he began a preschool which was on a farm...wonderful but, we discovered that he was highly allergic (both his dad and I are too...big surprise). We tried Zertec, Claritin, steroid nose spray and some asthma meds since the post nasal drip of the allergies seemed to cause him some reactive airway reaction. Finally, after a chronic sinus infection progressed into pneumonia, we changed schools. He also began allergy shots...and was somewhat improved. However, one symptom which never went away for very long was a nightime cough. At first, we would treat him with a nebulizer (asthma treatment) which we would do with him sitting on my lap (while asleep) in a rocking chair whenever he coughed. Then, the cough would stop for the rest of the night. One night, we discovered that the cough also stopped if we just sat him at for a while and rocked him without doing the nebulizer breathing treatment. So, it seemed like being upright was the cure. Anyway, he did much better for a few months. Then, in April or May, the night cough worsened. Our allergy dr. suggested using some other asthma type meds...pulmicort, singulair...but, it kept getting worse...so, he increased the dose....We described the symptoms of the night cough to him: While asleep, our son appeared to be swallowing constantly....in the am, he had really bad breathe....and was 'horse'sometimes in the am....and the cough responded to being held up right or propped up in bed. The dr. finally said "sounds like it might be GERD"...and we said "NO WAY" since he had never had a problem with vomiting or anything. So, we continued treating "asthma" and scheduled a visit with an ENT to see if there were any problems with the sinus area. Shortly before that appointment, our poor baby began to vomit bile and had a lot of discomfort. So, we thought "maybe that GERD thing is a part of this." Results of the CAT scan and the ENT's scope of the upper area of the nose and throat showed normal sinus and throat except for redness around the vocal cords. He said "GERD". Well, in reading about 'silent GERD', we realized that we had been doing everything the literature said NOT to do for GERD. For the two weeks previous to the episode of vomiting and pain, his school had been having 'pizza parties' to celebrate birthdays, going away parties, graduation parties, almost everyday (we figured that he ate pizza 8 out of 10 days), we also always ate dinner late and also had dessert right before bed. In addition, our boy had always eaten 'like a camel'...he ate LARGE amounts when the foods were his favorites and then would eat nothing for the next meal or two! So, we made MAJOR changes...gave him a very bland diet, propped up the bed, no eating after 5 pm, frequent smaller meals and he began PREVACID 15 mg. once a day (an hour before dinner). Well, we couldn't believe it but, his night cough stopped the very first day we did all this. We were estactic. Then, we went on vacation and could not do everything as strictly and the symptoms returned. We hoped it was the upheaval of the trip along with not having the bed propped, and letting him have pizza a couple of times and not always being able to eat as early. When we got home, we returned to the strict lifestyle but, never were symptom free again. We also noticed other more digestive symptoms whenever he had 'irritating' foods: burping, hiccuping, swallowing as if he was having trouble or pain. We called the dr. and he said we may need a stronger dose of Prevacid. I didn't want to do that without futher investigation so, we got a referral to a Gastroenterologist. When we saw him, he listened to the whole story and said he wondered if it was really food allergy and wanted to scope my son to establish whether GERD or food allergy was evident (he said they look different and he would do a biopsy to be sure.) Meanwhile, this has all taken so long that...guess what, the symptoms again had improved..no night cough, burping, etc. During the week leading up to the procedure, the dr. wanted us to be sure we gave our boy all the foods we had been avoiding in case there was an allergic reaction (we had been trying to see what eliminating mild products would do since once he told me "get it out" and pointing to his throat after drinking milk). When we reintroduced cheese, ice cream, yougart, milk...no reaction. But, when he had pizza, he showed some of the old symptoms: burping, saying "my throw up is coming up but, I swallowed it", He also seemed to have something happening while eating french fries (difficulty swallowing, hiccups).
Finally, we had the scope yesterday. The good (but confusing)news is that the esophogus looks perfect: NO signs of food allergy reaction and no damage from GERD. All the dr. would say is that, as far as his part goes, there is NO PROBLEM. He said that POSSIBLY the reason it looks good is that we have been using the Prevacid...but, he is not sure. He said he biopsied the lower esophogus to be sure but, he thinks everything is fine and he sees no need for us to continued the Prevacid!!!!!

So, I told that whole story to ask : What now? We KNOW that something happens when he eats irritating foods. I think the reason everything looks so good is that, ever since May, except for vacation time, we have been restricting everything...We are willing to do whatever we must for our child but, it seems that we are missing something here. We will go back to the allergy dr. on Sept. 8th to talk about all this.

posted 09-05-2003 11:15 PM            

As said before me, your son does seem to have text book symptoms. And an endoscopy showing no reflux etc would normally make a doctor suggest that a medication should be stopped to see how he progresses.

My grandaughter is 19mnths old, if we stop her medication for any reason, when she returns to them she never quite gets back to how good she was before. She is also having an endoscopy on the 17th and an impedance test. Like your son, she can have a terrible cough. Her mother has all your son's other symptoms, she is also asthmatic like myself.

I must say that there is a lot of medical evidence to support that reflux is often caused by food allergy. For others it could be a sign of an immature sphincter, the valve at the top of the stomach.