#002 What can be mistaken for acid reflux?

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Last updated on May 18, 2021

Many children though to have reflux may actually have something else going on.  This is especially true if we are discussing pathological reflux.  We are not talking about those children who spit up every once in a while  If a young child has vomiting,  excessive crying, and weight changes, we are not talking about run-of-the-mill reflux.  We are talking about something else, and I want to spend this episode discussing that. What are some of these mimickers of reflux?  

On the Doctor Evka website, in the "about" section, you will find the wording, "Click here to get a list of diagnoses that might mimic reflux."  That list is huge.   I will link to it here.

Some of the medical conditions on that list include non IgE-mediated food allergies, FPIES, eosinophilic esophagitis, various motility disorders, cyclic vomiting syndrome, etc.  When people attribute young children's symptoms to these other medical conditions, are they disregarding these other diseases?   

Such disregard can happen when it comes to diagnoses.  Did you know that the youngest children for a given grade level are at high risk of being diagnoses with attention deficit hyperactivity disorder or ADHD?  This is compared to children in the same grade who are older.  If a third grader is born November, for instance, that person is more likely to be diagnosed with ADHD compared to a third grader who is born in July.  Both children are at the same grade level, but the younger child might naturally be a bit more immature.  When you are told by the school that your younger child might need to be evaluated for ADHD, perhaps what the school is actually describing is a case of immaturity.

In the same way, parents might be told that their children have reflux.  In fact, it is a common diagnosis that is often given in the first six months of age. Not even necessarily by doctors but also by other members of the general public!   Some children who cry a lot, have feeding challenges, vomit, or have changes in their growth curve may be prescribed medication for reflux.  Even if doctors don't prescribe it, perhaps a friend tells them, "Give your child a medication for reflux; you can even buy these medications without a prescription." 

Yet a couple of good, randomized studies suggest that there is no benefit to the treatment of reflux in young children with acid suppressors.    If you give these children histamine blockers or proton pump inhibitors to treat the symptoms of reflux, the children might not get any better. 

There's a free course about one of the treatments of reflux with some of these acid suppressors on my website - DoctorEvka.com.  I'll link to it here.  

The free course is worth taking if you ask me.  

Why then is it that some caregivers swear by acid suppressors? Why do they say that they gave their children acid suppressors, and their symptoms seemed to get much better.  Were they lying?  I don't think so.  I believe them.

Part of the reason why some children improve with acid suppressors is not because these children have reflux.  It could be because these acid suppressors treat other medical conditions - not just reflux.  In some cases, they are actually of benefit. Again, I discuss this in my free training.  

In the interim, I want you to understand that acid suppressors do not treat run-of-the-mill reflux as defined in my prior episode.  (That's the episode in numeric order that comes right before this one.)  In fact, there are risks to acid suppressors. For instance, some acid suppressors - like proton pump inhibitors - actually carry a significant risk with them. Children whose stomach acid is lowered may be at increased risk of developing lower respiratory tract infections like pneumonia.  Stomach acid works as a line of defence against infections.  When the stomach's contents become less acidic, a child's may become more vulnerable to infections.

One of my goals on the Doctor Evka platform is to give you a better sense of what exactly your child has.  Is it just run-of-the-mill reflux?  Is it something else?  To learn more about how you can figure this out, I can link you to the following section.

Three "legal" things:  First, either a male or a female could consider themselves to be a mother.  My job is to serve and not to judge.  Second, although I am a family physician, I am not your doctor or therapist.   Please see your and your child's doctor.  Third, the information presented here is for educational purposes only.  It does not constitute professional medical advice.