#060 WHAT IS BEHIND THE VOMIT WHEN REFLUX MEDICATIONS ARE NOT WORKING

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Last updated on May 5, 2021

Little Peter stared at the vomit pooled beneath him.  His outfit was stained with liquid stomach contents.  Sweat dripped down his brow as it passed through his brown hair.  There was formula in its liquid form as well as cracker, still mostly intact.  It covered his shirt. Peter's mother held him tightly in her arms.  She kept him upright in hopes that the vomit would not go down the wrong way.  It was a sight to behold.  Her clothes were soaked to.  On her hair were pieces of undigested food, and her eyeglasses were covered in a thin brown mist.   She wiped the last of the vomit off Peter's lips and then cleaned her face as well with another towel.   Then the torrent of vomit came again.  This time, it seemed even more forceful than the last.  More vomit on their clothes!  More  vomit on their bodies!  More vomit on the floor! The stench of vomit filled the air with a pungent odor.   Peter's mom thought, "Oh no! There it is once again."

This time, Peter's mother had a plan.  When the whole ordeal was over and both of them were washed and in new clothes, she picked up the phone. She looked through her list of contact numbers until she found just the right one.  There it was.  The number that she really wanted!  The phone number of Peter's family doctor who worked alongside pediatricians in the same medical office.  All of them seeing children!

She dialed the phone number and explained again what happened. Little Peter had vomited once more, and they needed to be seen for a medical visit.  Perhaps there was something that the doctor could do to help them.   Lately, there seemed to be a lot of episodes of vomiting.  The receptionist on the other side of the phone line told her, "Tuesday!  You can have an appointment with the doctor on Tuesday".    Tuesday?  Just a day way! 

The next day, Peter and his mother found themselves at the doctor's office.  They sat down in one of the office exam rooms and waited patiently for the doctor to come.  When the doctor came into the room, Peter's mom stated, "My son has been vomiting a lot."   The doctor and Peter's mom had a back and forth conversation in which the doctor eventually diagnosed Peter with reflux, and Peter was sent home with a prescription for a histamine 1 blocker.  

Mom couldn't wait to get to the pharmacy. She couldn't wait for Peter's frequent episodes of vomiting to the end. She hoped that the medication -  a type of histamine 1 blocker - would do the trick, and Peter would feel so much better.   No more frequent episodes of vomiting was the hope.  Peter's mom certainly hoped that this would be the miracle drug.

What happened?  That day, after Peter took his medicine, he continued to vomit.  The next day, despite the medicine, the vomiting continued just as frequently as it did before.  Peter's mom thought, "Was it the wrong dose?  Was it the wrong prescription?" She couldn't figure out why Peter continued to vomit so much. 

This is the topic of the next few blog post (#056 and #057).  When you have a young child who is vomiting, what does that mean?  How do we know if it is reflux?  What if it is something else?  How do we go about figuring this out, and what are the similarities and differences between some of the different causes of vomiting in young children?  For instance, what are the similarities and differences between reflux and food allergies including FPIES?


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. 

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