My 2.5 year old daughter, Elana, is on Prevacid, Singulair, Nasonex, Pulmicort, and albuterol. She has chronic wheezing and coughing. She is aspirating into her lungs but her Ph Probe was normal. This is very strange to me. Elana had a swallow study/upper GI that showed there was a delay in her stomach emptying. It took 15 minutes for her stomach to empty. Does anyone know what the normal time is? What is everyone's time so I can have some perspective? Also, during the time she was under the "x-ray" machine, which was 20 minutes or so, she did not reflux. This also doesn't make sense to me since she is aspirating. Has anyone's child showed reflux during an upper GI/swallow study?

My 2.5 year old daughter, Elana, is on Prevacid, Singulair, Nasonex, Pulmicort, and albuterol. She has chronic wheezing and coughing. She is aspirating into her lungs but her Ph Probe was normal. This is very strange to me. Elana had a swallow study/upper GI that showed there was a delay in her stomach emptying. It took 15 minutes for her stomach to empty. Does anyone know what the normal time is? What is everyone's time so I can have some perspective? Also, during the time she was under the "x-ray" machine, which was 20 minutes or so, she did not reflux. This also doesn't make sense to me since she is aspirating. Has anyone's child showed reflux during an upper GI/swallow study?

Iain had the milk test and did show reflux and mild aspiration, but this test is not the best one to show aspiration. He was also diagnosed with DGE in this test.

According to what we were told a "normal" child will empty out stomach contents by 50 to 70% within one half hour and the rest is gone by the end of one hour. I do not understand how she would be classified with DGE if it took 15 minutes for her to empty. It could be that the test we had has different emptying times? I do not know.

So many on the board have children who did not reflux during testing. Mine did and we had the tech actually fly into the room more than once in a screeching hurry as he refluxed so great but he was still classified as mild to moderate. Go figure.

The machine is not the best to determine aspiration. From what I have been told, an actual x-ray is the best way to determine aspiration.

As far as DGE goes Iain was only emptied out 24 % within the first hour and was at 45% at the 2.5 hour mark. He is not on any DGE meds as yet. Makes me wonder sometimes if we are fighting a losing battle to have him get up to speed on eating when he clearly has DGE issues.

Anyway, I would assume that not all kids will reflux on the table nor have their reflux noted. The ph probe is supposed to be the gold standard for reflux diagnosis but as I have not had it done I have to defer to others who have.

Again the machine might not have been the best one to pick up on the aspiration, so I would ask for another test involving an x-ray to determine this. Or you can skip testing altogether and go with her symptoms as many peds do. It struck me as very odd to hear that but it is a common way of diagnosing and treating GERD.

Did the xray radiologist actually write in the notes to your doctor that ordered it that she had a delay in emptying from her stomach? Sometimes they say one thing to you but write something different in the notes to the ordering doc. What they write on the notes is what they are willing to put their liscence on the line for, so make sure it is the same.

First of all, an upper GI is not an acurate test to measure true gastric emptying time. The only test that does it acurately is a test called a gastric emptying scan. This is mostly because pure barrium, like what they drink in an upper GI with a small bowel follow through, goes much slower than regular food. A gastric emptying scan uses real food---whatever they typically eat--and it is laced with barrium.

Second, 15 minutes is not a delay according to the standards I have been told. I was told the same thing that Leigh was told. To give you more perspective, my son had the upper GI with a bowel follow through and it took 4 hours to leave his stomach AND small bowel. Then the radiologist wrote down that he only had a slight delay! He is having a gastric emptying scan on Monday to discover whether or not he truely has a delay.

Because the initial test used barrium, our GI said it is not accurate of him on a typical day. When we go on Monday, they will use his formula to test it.

Also, depending on where you got the test done, babies and children digest at different speeds than adults, and sometimes a radiologist that typically reads adult studies will compare the child studies the same way. One last thing to consider is that all kids with acid reflux have some level of delayed emptying, even if only very mild. In order for them to meet the reflux qualification of refluxing more than an hour after eating, there needs to be a mild delay in emptying. That is why a gastric emptying scan at a lab that regularly does pediatric exams is important in determining if there is a significant delay that requires treatment.

Also, it is common for them to not reflux on the upper GI table. She was there for 20 minutes---how realistic can that be? If she refluxed everytime she drank something minutes after drinking it and refluxed it into her lungs everytime she did, I am sure she would have had a fundo a long time ago. Because she doesn't, you can count on it to not show up on that test. The other thing I thought of is that barrium is much thicker than regular drinks, and would make it harder to be aspirated and refluxed then say water or juice. Again, a gastric emptying scan is more accurate in showing reflux into the lungs because it uses what they regularly drink and they are watching it the WHOLE time it takes to empty completely--so usually for hours in kids that go through this test.

The only accurate way to measure reflux is a 24 hour ph probe. Now you say her results were normal. Did she go off of prevacid long enough before being tested? Did she drink the applejuice at regular two hour intervals and drink enough of it? Are they sure the probes were in the right place? Could it have been a fluke day? During the test, did she seem like she was having a good day in particular or did she seem pretty typical to you? We all have good days sometimes.

Last question, when she refluxes, does she reflux into her lungs or does she aspirate when she swallows?

Sorry this is so long, hoping it helped!:wink:

Thanks for all the info. What's frustrating with Elana is that a majority of her tests are coming back normal. She was off Prevacid for 2 weeks before the Ph probe and ate and drank quite a bit while the probe was in place. The probe was in place and was working fine. Her swallow studies and upper GI's and x-rays also came back normal. There were no fistula's in her esphogus, throat, etc. We know she is aspirating into her lungs b/c the doctor did a bronoschopy and took a sample of some of the cells. He found "fat cells" in her lungs that are suppose to be in her stomach. However, with all the tests coming back normal, we don't know if the food is coming back up to her lungs or when she swallows. Very, very frustrating. She is wheezy and gurgly all the time. Even with all her breathing treatments and asthma meds. Her doctor is hopeful that she will outgrow her reflux and the asthma as well. My husband and I do not have reflux or asthma. Neither of our families have it either. I have 2 sisters that have children and all their kids are very healthy. They didn't breastfeed their kids either and I did with Elana and she is sick all the time. I am just so very frustrated.

Leigh and Carla said it all. I too would question where the aspiration is coming from and wouldn't rule out reflux but at the same time be considering another cause. Since she didn't reflux during the tests she could just not reflux that often but when she does it is high, or it could be aspirating into her lungs when swallowing.

Anyhow, to answer one of your questions, our sons tummy was still full and swollen after over an hour and it never moved from the top to the bottom of his tummy and we stopped the test as obviously it is a major delay and that was during an emptying scan specifically for emptying problems.

Please let us know what you find out and keep us updated on the situation. (((((hugs))) I understand how frustrating it is trying to find the cause so you can get your child help. We are here for you!

Oh, and our son also refluxed horribly through all his testing and it was obviously bad, but many on here have kids with major reflux that WAS NOT diagnosed with the same tests.

Maiya did not reflux while on the table, but the ph probe showed 219 episodes in 24 hours. Go figure!