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mr 14 and the Nissen Fundo he had at 1 year old..

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Posted 5/14/2012 10:57 AM (GMT 0)
Hi guys,

would appreciate some advice please?

My 14 year old son had severe GORD from birth, meds failed so he had a Nissen at 1 year old (he was only the second 6kg baby in Australasia to have it done with a laparoscope)
nyway, he had a gastrostomy til 4 as he still wouldn't eat.. overnight something clicked and he started eating..

fast forward 10 years..

he's still small (bone age puts him a few years behind chronological) and has Aspergers. He has also been having trouble with swallowing... and here is what I need advice on please.. He can barely even swallow water now without pain in the middle of his chest. poor kid and his anxiety is sky high over it (an aspergian trait). Our gp has referred him for a gastroscope because he thinks perhaps the Nissen may have tightened? Is this a possibility this many years down the track? and is a scope the best way to diagnose this?

If he needs it redone (the gp said they do 180 degree wraps now instead?) he would have to go down to a paed surgeon in Brisbane (we live in Cairns at the top of Australia - a 48+ hour drive/2+ hour flight).

I would like to minimise the anxiety for him so the less tests the better..

Post Edited (Leebie3) : 5/17/2012 11:46:40 PM (GMT-6)

Posted 5/14/2012 6:59 PM (GMT 0)
HI Leebie,

Hi, has he mentioned anything about manometry testing? Dysphagia (difficulty swallowing) is a common symptom of an esophageal motility disorder, but it could be a problem with the wrap.

I don't know how things are done in Australia, but from what I've seen here and read elsewhere, a Barium swallow can also diagnose a leaky or too tight wrap. I am in Finland and they don't do them here anymore, but maybe they do there?

Also, if his anxiety level is too high, it is possible for him to be gastroscoped while either lightly or generally (all the way under) sedated for the procedure. You doctor will be able to discuss your options in much more detail.

It does, however, sound like the doc is on the right track in checking the wrap. I would suggest making another appointment if there are points you're not clear on.

Keep us posted on your son's progress!
Ashley
Posted 5/15/2012 6:00 AM (GMT 0)
thanks Ashely :-)

They give them a general anaesthetic under 16years old here for a gastroscopy. and they have said that I can be with him until he goes to theatre and when he is in recovery (much the same as if he were a younger child)..

not sure about the other tests.. would the gastro doc decide to try them first? I think it they so a barium swallow they'd have to tube him for it. It's not the actaul swallowing he has trouble with.. just the extreme pain when the food seems to get stuck when it reaches the middle of his chest which is where the stomach wrap is yeah?
Posted 5/16/2012 4:24 AM (GMT 0)
ok, so I just learnt something new reading through this forum :-D My son didn't have GORD.. he had LPR. they did a gastroscopy and the valve at the top of his stomach opened when he inhaled instead of when he swallowed.. that'd be LPR right?

Post Edited (Leebie3) : 5/18/2012 7:23:36 PM (GMT-6)

Posted 5/19/2012 1:24 AM (GMT 0)
good news! I called the hosp to check on his referral (they had lost the first one) and he's in on the 7th June! :-)

How much will they be able to tell from a gastroscopy? I would have thought as suggested above that a barium swallow would show it better?
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