View Full Version : Symptoms of Reflux with a G-tube?
05-23-2011, 01:58 AM
One of Gemma's trach doctors thinks she might have reflux because her heart rate dips when she is in a deep sleep. I don't think she has reflux at all because she is a sound sleeper, sometimes she is just really tired after a long day. She has no vomiting or signs of food intolerence. My question is, do any of your kids with a g-tube experience reflux and what are the symptoms? Are there ever not any symptoms?
Also, for those of you with oximeters, what is your childs age and sleeping HR? My daughter is 15 months and since having her shunt surgery can reach the 50's when sleeping.
I just don't think she could possibly have reflux.
05-23-2011, 08:02 AM
Ashton has suffered from reflux his entire life. One of the first indicators was when we first started doing bottle feeds. He would drop his saturations VERY low (like 30s).
Once we went to a gj tube at 10 months of age and no bottles there was no risk of him eating orally.
Fast forward four years. We were inpatient because of his constant desats. We did a ph probe study and he had almost 300 episodes of reflux WITH a gj tube!!!!!!!!!!!!!!!!! I was stunned. They then went in and did a bronch with lung wash and it came back that his lungs were 40% fats from micro aspirations...obviously over the years prior. Doctors were surprised as well because for one, he had the gj feeeds and the main reason being Ashton was SO happy and showed NO signs of reflux. It was "silent reflux".
So, it is very possible that she has reflux and you don't know. However, I don't think her low heart rate would explain it alone. Ashton is usually in the 50s and has been for a while.
After the ph probe and the lung wash we HAD to do a fundo. His desats never corrected (which they thought were related to reflux) so they were at a loss.
Since switching him to a blended diet just over a year ago, his reflux has improved IMMENSELY.
Some other symptoms of reflux are burping, coughing during feeds, hiccups, repetitive swallowing, gagging........
Hope this helps a bit. :)
Sweet Harrison's mommy
05-23-2011, 09:19 AM
Harrison is 6 months old and his HR will sometimes dip when in a deep sleep. For him, dipping is getting to the 80's, but then it goes right back up. As far as reflux, Harrison did have severe reflux (with all the symptoms!) and received a fundo at 6 weeks. However, they never attributed his HR dips to reflux. A few of the doctors thought that his HR would dip early on in life because he wasn't handling his secretions as well during sleep, so they would build up, then he would have to take a large swallow, causing his HR to dip momentarily?? Just a theory. He seemed to grow out of his HR problems, but they never once attributed the issue to reflux.
Hope this helps!
05-23-2011, 11:14 AM
Alexander sleeps amazingly deeply - even when we weaned him from the vent, he rode the vent at night, and had HRs into the low 50s from time to time......but he's also the kid who, even now at almost 3, you can do *anything* to him when he's out, and he won't wake up. We used to depend on that - doctor's appointments at nap time to get blood work without a hassle, for example, no-hassle trach changes....we've put electrodes on while he sleeps that he won't tolerate while awake, including the ones for the ABR hearing test, because he had to sleep for the test, and the tech couldn't get close enough to him to get them on while awake. Clearly, this is just Alexander.
It's certainly possible to have "silent" refllux - and it seems to me that reflux is maybe more common in g-tube kids, just because of the additional irritation on the stomach from the darn tube. PH & impedence probes are not the be-all-end-all of reflux tests either. I know our ENTs both look for signs of reflux when doing scopes.
05-23-2011, 12:20 PM
Caleb is almost 9 months- his HR dips into the 60s when he is in deep sleep but no reflux issues really
05-23-2011, 12:28 PM
Maddy had bad reflux and it caused her to have apnea. But went away with meds. Now she is off all meds and is doing fine and has not had a apnea spell in like 10m. When she sleeps her heart rate is around 90-97 with dips around 83
05-23-2011, 05:23 PM
My little guy is almost 3 and recently his heart rate started dipping while in a deep sleep (it was going into the 30's). His cardiologist ordered a holter monitor that he wore 24/7 for 21 days. They determined it was nothing to worry about and diagnosed him with sinus arrythmia. They said even though the oximeter read in the 30's it was really around 50-60. The heart rate was so slow that the oximeter probably read it as skipping a beat so it would drop even lower. We were quite worried because it would stay low for a few minutes. He was cleared but I still think it is strange that all of a sudden this started happening. He has 2 repaired heart defects so we were panicking but he is fine and also his oxygen sats stayed normal? He is supposed to get his trach out next month so we didn't want this to hold him back. Good luck, I would call the cardiologist just to be on the safe side.
05-23-2011, 07:26 PM
Yes a child can show no signs of discomfort from reflux and still have it. In fact Ainsley had 2 or more negative PH probe tests. An impedance probe test showed reflux reaching the upper part of the esophagus 100+ times in a 24 hour period. She did vomit, but was not baby spit ups like you'd expect. We are talking full vomiting, often projectile, frequently as after coughing up trach secretions. Even given our experience I'm not sure I'd just to the conclusion of the doc. Ainsley's heart rate was always on the high side and still is. Never did I see it drop.
I would be interested in how much variation there is. If her resting heartrate is not much higher perhaps it's just because she's sleeping deeply like you said. Though 50 is low.
Collin doesn't show signs of reflux either. What I notice is that he eats less when he's off the medication. Can't heart to try the medication if the doctor is suggesting it. See if it helps with HR etc... :)
05-24-2011, 04:22 PM
Isabel has reflux. If the reflux is causing apnea it can causing heart rate dips if they are holding their breath to avoid pain. At 15 months I would think 50's is not to bad. Isabel is 5 months and her alarm is set to go off at 70. G tube can make reflux worse but with Isabel it tends to make her HR higher due to pain. If she is not vomiting, losing weight or having other issues I would personally not worry. If it ain't broke don't fix it.
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