Results from Endoscopy

There was good and bad news that came from Tye’s Pediatric G.I. doctor.

The bad news is that Tye is refluxing and aspirating. Gastric juices and slightly digested food is refluxing up the esophagus and going back down the bronchial tubes (part of the lungs). The biopsies of the bronchial tubes showed several lipid-laden macrophages. I’m going to try my best to explain what these are….lipid-laden macrophages are white blood cells that the body makes to clean up what shouldn’t be there. These would not be present unless aspiration is ocurring. The doctor referenced pac-man to describe them.

The good news is that the other biopsies of the small intestine, the esophagus and the stomach showed that they are healthy at this point. This means that the prevacid that Tye takes is doing it's job which is to heal any damage from the reflux.

Aspiration can cause a number of serious illnesses like pneumonia or a lifetime of Asthma. At this point we are seeing croup like symptoms….the doctor says this can happen after Tye has a large aspiration. We are seeing this after he has been laying flat for naps and over the night. He will wake up with a croup like cough. If it gets bad enough like we have had in the past he can be treated with steroids to shrink some of the swelling in the esophagus. The reason we have not found the steroids to work in the past as well as they should is because he is not actually catching croup like other kids can. It is actually symptoms of the reflux & aspirating.

Anti-reflux surgery called fundoplication of the stomach has been suggested to help Tye by the P.G.I. doctor. The pediatric surgeon will wrap the upper portion of the stomach partially or completely around the esophagus at the junction where the esophagus meets the stomach. This creates a one way valve such that liquid and food cannot reflux back into the esophagus.

In most cases this procedure is done laparoscopically. Small incisions will be made: one in the belly button, one up high on the stomach ,and two in the lower abdomen. It only is done open when there are other organs, like the liver, in the way or the child is super tiny.

The hospital stay can be anywhere from 1 night to 7 nights without any complications. Depending on the child’s needs, a feeding tube, or g-tube, may be placed into the stomach at the time of surgery. We should know more about this after meeting with the peds surgeon on October 15th. The g-tube is used to burp or relieve any bloat. Also, it can be used for feeding if necessary, or for extracting in the case of the need to vomit. It will take time after the surgery for a child to be able to do these things on their own.

Recovery time can be different for every case. Our doctor informed us that it could take up to a year for Tye’s “insides” to heal. Generally, a six week liquid or pureed diet is recommended. After 6 weeks solid food will be reintroduced slowly.

This is what I know and understand right now….I will be updating my information after speaking with the surgeon in a couple of weeks.