Sunday, May 30, 2010

Fire in Her Tummy

My sassy niece Emma has reflux, and she used to tell her parents all the time, "There's a fire in my tummy!" We've known Becca has had a fire in her tummy for some time now. Like most preemies, she's been medicated for reflux since she was in the hospital. We've just been upping her dosage as Zantac as she's grown, hoping that she would simply grow out of the reflux, too. (Most kids do.) As a kid moves from bottles to solids, you usually see less of the characteristic spitting up and back-arching during feedings, so its hard to tell if she is actually still suffering from reflux (at least until she is able to tell you about the fire in their tummy!). So what do you do? You have an upper gastrointestinal study done. Which we did.

It's a simple procedure if the patient cooperates (as our patient did). We put Becca in a gown (huge and adorable), and then laid her in a couple of different positions while she drank some glow-in-the-dark milk (a.k.a. flavored barium). Since she hadn't had anything to eat or drink in 14 hours, she was happy to oblige. They snapped a bunch of pictures to see how the milk moved through her system. They were checking out the anatomical structure of her g-i tract and looking to see if the milk stayed in her stomach once it got there.

The first part was great. Everything went down beautifully, as you can see below (the long dark stripe is the milk going down her esophagus and into the black pouch, which is her stomach):

But here's where things went awry. (Okay, it wasn't that different than we expected, but I wanted to say the word "awry." I lead an exciting life.) This picture was taken after she finished drinking:

See the dark stripe-y thing now? And how it comes nearly all the way up to her chin (the semicircle at the top of the screen)? Yeah, that's not milk going down...that's milk coming back up...milk, that is, that has been in her stomach and mixed with stomach acids and other gross stuff.

No wonder she doesn't like to eat.

I don't know what the next step is; I haven't heard from the GI doc. Maybe we don't do anything until we see him in a couple of months. We still have to collect a poop sample because little missy refuses to poop on a day when we can actually get to Vandy to drop it off. I have a feeling, though, that we have to do a more invasive test now to measure the acidity of her stomach, which involves snaking a very long piece of tubing down her nose and into her stomach and leaving it there for 24 hours. Without sedation or anything. Sounds fun, doesn't it? Nothing we can't manage, though...just another thing to add to the list of procedures - of of things to do over the next few weeks!

Emma's done it before, even multiple times, I think. Good thing...'cause Becca's going to need a sassy girl to sassy girl pep talk! :)


  1. If I am remembering correctly, that first picture is actually reflux as well, going all the way up her esophagus.

  2. Nathan had the same study done at 9 mths. NOT fun - sorry! He was on three different reflux meds - one as a trial - only the third infant in the nation to be on it. Had to wake him 2 hours before a meal to give him a med, another 30 minutes before a meal and the last 2 hours after the meal. Obviously, it didn't do much to stunt his growth - at 5'10, 165 lbs. Something must have worked! Hang in there!