What is the treatment for nausea and pain while swollowing due to mild linear furrowing mid-oesphagus?
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My son 12 yr old as as soon as he eats he throws it out. He gets a mild pain while swolling food by center of chest. We have taken him to hospital for endoscopy finding oesophagus was normal. The entire examine stomach was normal. The examine duodenum was normal. Only says possible mild linear furrowing mid-oesphagus. He is been since taking omeprazole almost 4 months now no real improvement please let me know as we are worried. Thanks.
Posted Mon, 13 Jan 2014 in Digestion and Bowels
Answered by Dr. Shafi Ullah Khan 2 hours later
Brief Answer: I suspect EoE,Needs Work up to confirm Detailed Answer: Good Day Mr Sahid! I am Dr S Khan and i would like to help you with your kid's dysphagia (pain during swallowing) and post prandial vomiting episodes. Mr Sahid i want you to know that all these manifestations and non response to PPI medications and no positive finding in Endoscopy these things point to a condition most common in kids called Eosinophilic Esophagitis( EoE) in which these linear furrowing are hallmark presentation. But to confirm that we need to rule out all other possible etiologies for these symptoms and for that radiology, manometry, 24 hrs PH monitoring, Blood work up, ESR, Eosinophilic profile, Eotaxins, Eosinophil growth factors IL 5, videoflouroscopy, swallowing electro myographies, and chemoattractant studies and a biopsy and a complete histopathological assessment. So you see the long way of management here. Its too early to diagnose and it needs a lot of work up and a good competent Gastroenterologists. I recommend steroids use and see if the symptoms relieve it will further increase my suspicions , till then al the kid needs is symptomatic treatment for relief and a strict monitoring of electrolytes and health and modification of diet planned by a dietitian. i recommend pudding, crushed potato, and ground meat, curd-type yogurt, orange juice (3% thickener mixed), cream soup, and thin soup with starch, tomato juice, fluid-type yogurt, and thick, fluid rice, water and orange juice. and last but not the least at least 8 weeks of an amino-acid-based dietary formula, Dyspahagia/ swallowing difficulty has many etiologic factors and what i mentioned is most likely from my point of view providing the facts and scenario. But to confirm and to make sure your kid gets the right treatment, I recommend competent gastro enterologist in your area i suppose New Zealand with a deep work up. Hope you get a perspective from my answer and a plan in mind to follow through. Mr Sahid i will be here for you if you need me. If you have any more queries please feel free to ask, i would love to answer. other wise i request you to kindly close the discussion and rate the answer as per your experience. Take some very good care of your kid and yourself.May the odds be ever in your favour. regards Dr. S Khan