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June 23, 2006 at 11:54 am #10381AnonymousInactive
Hello!
I needed help with trying to get info on what type of test should i ask them to do on her so that the dont misdiagnose her with something she does not have.she had an upper gi done already.I know i want them to do an eeg to rule out sezures.so what other test should i asked them to do?I know i should let them deciede but i think i should go prepared in case this is one of those gi i doc that just give you meds just cause.
June 23, 2006 at 12:48 pm #10385AnonymousInactiveYou mentioned seizures, just wanted to make sure you have seen this article: http://www.marci-kids.com/rigidbodyposturing.html
and this article regarding Reglan (metoclopramide):
5. Pro-Motility Drugs
Metoclopramide and cisapride are supposed to work by enhancing the emptying of the stomach and therefore are known as pro-motility or pro-kinetic agents.
They however have marginal efficacy and serious side effect potential, and can cause profound irritability and tiredness.
The best available medical studies and reviews of studies reveal that these drugs are rarely if ever useful. They usually get prescribed because the PPI drug being used is not being dosed properly.
Metoclopramide has caused shaking and jerking movements, sometimes rigid body posturing (acute dystonic reactions) which are often mistaken for seizures.
And this article about Zantac:
3. H-2 blockers
These are drugs such as Zantac® (ranitidine) and Pepcid® (famotidine) also older agents such as Tagamet® (cimetidine) and finally, Axid® (nizatidine). These drugs all work the same way. They block acid production by blocking the receptor primarily responsible for stimulating the acid-secreting cells known as parietal cells. The problem with these drugs in children is that children develop tolerance very rapidly to the effects of all H-2 blockers. This can happen in as little as one week. You will know it is happening because your child will no longer feel good. So in other words, they start feeling good when you start the Zantac or Pepcid at the beginning, and then a week or so later they are back to square one. A special note—never use H-2 blockers along with PPI drugs. This is because the H-2 blocker will prevent the PPI drug from working. It is ok to give a PPI drug at breakfast and supper and then four hours or more later at bedtime give an H-2 blocker. But this is not together.
June 23, 2006 at 8:30 pm #10412hellbenntKeymasterlansima wrote: H-2 blockers: never use H-2 blockers along with PPI drugs. This is because the H-2 blocker will prevent the PPI drug from working. It is ok to give a PPI drug at breakfast and supper and then four hours or more later at bedtime give an H-2 blocker. But this is not together.
I just wanted to emphasize that last sentence, that YES you can give zantac & a PPI in the same 24hr day- you just need to make sure they are spaced out & not given at the same time
Also: there are links from my welcome/intro about Sandifer symptoms (can look like a seizure)
Also: you ask about tests: if you think there’s DGE (delayed gastric emptying) then ask for a specific test for this- it’s not the upper GI, it’s something else- do a search for ‘swallow study’ and you’ll find it
Also: i gave you links about the malacias if you think these apply…
hellbennt2006-6-23 20:31:13
June 23, 2006 at 9:35 pm #10419AnonymousInactiveHere are some tests:
(I’m not suggesting you ask for all/any of these. Just listing some I know of for information purposes).
For Delayed gastric emptying- gastric emptying scan
For swallowing problems- there is a feeding assessment (usually done by a therapist) and a modified barium swallow (where the baby drinks something with barium in it and the swallow is watched on a screen to check for aspiration).
For malformations- an upper GI (the one you already had done)
For esophageal damage- endoscopy
For severity of reflux- PH probe
June 24, 2006 at 9:25 am #10425AnonymousInactiveHello!
Thank you Marsha,Laura & Lori for all your info.It Really is Helpful.I think i will be more prepared for my appt..Thanx
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