Abdominal pain
Question
Our teenage son was treated for H. pylori. He later had a fundoplication. Following that, an Upper GI with small bowel follow through took 5 hours to reach the cecum (first part of the large intestine). He was put on Reglan but continues to have frequent severe abdominal pain.
Answer of our experts
H. pylori can certainly come back. A breath test or esophagogastroduodenoscopy (EGD) would be helpful. If that is normal and there doesn't appear to be a problem with the Nissen fundoplication, a careful abdominal pain work up would be recommended. This includes looking at the kidneys, pancreas, ruling out Irritable Bowel Syndrome, etc.
CP/TK 7-13-10
Approved byClinical Advisory Board (CAB)
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Recommendation(s)
Gastrointestinal Problems
R28
Every new born suspected or proven to have CdLS should be carefully evaluated for signs and symptoms consistent with gastrointestinal malformations.
Recommendation(s)
Reflux
R32
Consider always gastro-oesophageal reflux disease (GORD) in any individual with CdLS owing to its frequency and wide variability in presentation, which includes challenging behaviour.
R33
Modification of nutrition and proton pump inhibitors (PPI) are the first-line treatments of GORD. Anti-reflux medications need to be used to their maximum dosage. Surgical interventions for GORD should be limited to those individuals with CdLS in whom nutritional and medical treatments have been unsuccessful or airway safety is at risk.
R34
If GORD symptoms persist, endoscopy should be strongly considered whilst an individual with CdLS is still in paediatric care.
R35
Surveillance for Barrett’s Oesophagus needs to be discussed with and decided together with the family, balancing the potential gain in health and burden for the individual with CdLS.
