How can severe reflux causing cyanosis and breathing trouble be treated?
Patient: Hi I have a 6 year old with special needs who suffers from reflux and has been medicated successfully for this for about 3 years. However recently her symptoms have returned severly especially at night with her waking unable to swallow the reflux and turning blue with trouble breathing. Any ideas on what to do please? Doctor: Hi,It is commom for children with special needs to have this problem because of lack of proper coordination of breathing/swalloing muscles and poor tone esophgus. Usually this will respond to acid reducing agents like lansoprazol.  Also, few non pharmacological  will help- give dinner few hours before bedtime, make him sit upright for 30 minutes after a meal, increase consistency of diet to a more solid / semi solid type, keep the head end of the bed elevated to about 30 degree from horizontal, and avoid caffeinated things like tea / coffee / similar items.If these measures does not help, we rarely need a fundo-plication procedure after ruling out other causes like LPR (laryngo pharyngeal reflex) and pertusis. Your doctor will guide through this.Hope I have answered your question. Let me know if I can assist you further.  Regards, Dr. Muhammed Aslam T. K., Pediatrician