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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes persistent vomiting in a microcephaly seizure disorder patient?

I have a student that has CP microcephaly, seizure disorder, asthma ftt, scoliosis, dysgraphia, gerd, sinusitis, constipation, delayed gastric emptying, vitamin D deficiency, and anxiety disorder. She is fed via G-tube 7 times a day. 5 times I heard facility into times at school. She takes peptamen Jr, cetrizine, Klonopin, erythromycin, Fluoxetine, Prevacid, vitamin D3, and zinc sulfate, albuterol when needed, and Prevacid 5 days before her menses. She is 16 years old and weighs only about 56 lb. She throws up her feeding at school everyday. She throws up on her facility as well but sometimes they deny it. At one point in her life they had a ring around some tube to prevent the food from going back up, but I was told that ring has dissolved or something. So my question is is there other things possibly to do to stop her from throwing up as she has lost so much weight and it seems as though her doctors and the facility don t seem to care or see it as a problem. She has been my student for a year and I m pretty sick of it so we have a meeting scheduled with her doctors, her mother, who doesn t speak English and is from Nepal, facility nurses and doctors and caretakers and the nurse, director and myself at the school. I know this was a lot and a complicated case but I really wanted to know if you might have any quick advice or ideas that might help me ask the right questions or suggest something, Etc
Wed, 8 Aug 2018
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Pediatrician 's  Response
Hello and welcome to Ask A Doctor. I have read you query and here is my advice.
Quite a while ago when I was medical director(I am a pediatrician) at a residential home for mentally challenged children and adolescents there was a child who had a problem like your student.
After conveying our child's history to the pediatric surgeon at the nearby University medical center, and obtaining permission from the judge who was his guardian, the surgeon took the child to the OR and performed a Nissen fundoplication. This operation wraps the upper part of the stomach around the lower portion of the esophagus to prevent stomach contents from refluxing up the esophagus and coming out of the mouth.
This will allow the patient to retain more calories and put on weight.
With an enhanced nutritional status her general well being will improve.
I hope the staff(teachers and medical) at your school appreciate your concern for your students.
Hope I have answered your query. If you have any further questions, I will be happy to help.
Arnold Zedd, MD, FAAP

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