Today was THE appointment with the gastroenterologist. We have been patiently and perhaps anxiously waiting for this appointment for about 2 months now.
Many of you who know Ellie have never seen her without a bib (yep, I take the bib off for the pictures). In fact, almost all who have met her have also seen her spit up. Then, there are the unfortunate few who got spit up on. Sorry! In the medical field, she is what we call a "Happy Spitter". Since birth, the Bear has spit up right after feeds and even hours later, yet she does not cry or arch her back. Thank goodness! Hence, happy spitter.
We tried some treatments and then figured that like all babies she would outgrow it around 7 months of age or a little there after. After months of happy spitting, it started to get worse and then it was happy spitting with chunks of solids in it. Yes, gross. Yes, I had to share. Laundry was/is a daily ritual and mostly because of a need for more jammies or bibs. Sometimes I would go through 4 sets of PJs before I could get her to bed without any spit up on them. I began to worry about her esophagus and the damage that all of this acidic reflux was causing.
Oh and then the horrible pooping issues. Do not fear, I will not go into detail, but let's just say she has been on Miralax for a year now.
We left the office with 3 diagnoses, 2 medications, and an order for 1 test.
All of this can be attributed to her low muscle tone. Remember, we have muscles everywhere--even inside the GI tract. Poor tone means she has trouble keeping the food down in her stomach. It creeps up through the esophageal sphincter--Reflux [GERD]. She has gastric paresis or delayed gastric emptying so the food just hangs out in the stomach a little longer. That means more time for the food to eek out into the esophagus and then out of the mouth. Yuck. Hence the random pea, blueberry, or chunk of corn that ends up in the spit up. Then, the slow moving intestines allow for more water to be absorbed, the stool to become harder, and the lower tone GI muscles having trouble pushing. There you have the constipation.
We are to start up Pepcid for the reflux, erythromycin (very low dose) to increase GI motility, and continue on the Miralax. We also have an Upper GI study scheduled.
As for the milk issues (note, we stopped milk after a stomach bug and the spitting up was cut in half). We are going with milk intolerance and sticking to rice milk.
Ear tubes tomorrow!