By Bonnie C. Minsky MA, MPH, LNC, CNS
The number of cases of children diagnosed with Gastroesophageal Reflux, or otherwise known as GER or Acid Reflux, has skyrocketed over the last 5 years. According to the Mattson Jack Group, in 2004, approximately 7 million children and adolescents under the age of 17 in the United States suffered from gastroesophageal reflux. Hence, since 2002, there has been a 660% increase in spending to treat gastrointestinal disorders, most of those dollars going towards prescription medication.
In infants, reflux can be life threatening, so it is not something to take lightly. Doctors prescribe a variety of medications, including H2 blockers (Zantac®) and proton pump inhibitors (Prevacid® and Prilosec®). Most patients, and especially children, heal within four weeks. Studies available to date have not assessed the safety of reflux medications for more than 8 weeks. Yet, I have seen infants on medication for a year, and older children even longer. We have made medication a long-term solution for what should be a short-term solution, and only if dietary changes are unsuccessful.
Reflux is intricately linked with diet, but doctors and parents rarely look at the obvious. I have seen a multitude of children who have come to me after being on these medications. They suffer from severe nutrient deficiencies, have digestion and absorption difficulties, fail to grow or gain weight, exhibit chewing and eating problems, and often have developmental delays.
What is most shocking about this line of therapy is that, according to the Physicians Desk Reference, no research has been performed regarding medications to treat gastroesophageal reflux in children. Doctors routinely give drugs to children "off label," which means the drug hasn't been studied in children in adequate, well-controlled clinical trials approved by the Food and Drug Administration.
Reflux, especially in infants, is especially disconcerting for parents. What once was passed off as “colic” or excessive “spitting-up,” is now commonly diagnosed as GER. A child’s digestive pain may cause crying, writhing, and sleepless nights for parents. Because doctors are not trained to look for the cause of the problem (which I find very easy to discover with an infant or toddler), they immediately prescribe medication. Parents are also to blame if they look for the “quick fix” and won’t make a commitment to dietary changes as first line therapy.
Unfortunately, just treating the symptoms will not correct the cause of reflux. In most cases, the symptoms will return immediately when the reflux medication is discontinued. In addition, there are many instances in which the medication will only slightly minimize symptoms or not improve them at all.
The most common medications for reflux prescribed by physicians are Zantac®, Prevacid®, Prilosec®, Nexium®, Reglan®, Mylanta®, and Pepcid®. The side effects and vitamin and mineral depletion they create are alarming. Too many times have I seen a young child who has been damaged mentally, physically, and emotionally from reflux medications. Whether suppressing the production of stomach acid (H2 Blockers), blocking its production (Proton Pump Inhibitors), or neutralizing it (Antacids), the damage is evident. Many of the adverse reactions are digestion-related. What is the point of fixing one problem only to create another?
Adverse reactions reported in adult studies of the most commonly prescribed reflux medication in children, H2 Blocker Zantac® –
Headache, sometimes severe; rare cases of malaise, dizziness, insomnia, vertigo, mental confusion, agitation, depression, hallucinations, and involuntary motor disturbances; tachycardia, bradycardia, atrioventricular block, and premature ventricular beats; constipation, diarrhea, nausea/vomiting, abdominal discomfort/pain, and pancreatitis; hepatitis, hepatic failure; athralgias, myalgias; gynecomastia, impotence, and loss of libido; rashes such as erythema multiforme, alopecia, and vasculitis; anaphylaxis, angioneurotic edema. ZANTAC EFFERdose also contains phenylalanine, the substance used in Nutrasweet/Aspartame. For nursing mothers on reflux meds, note that extreme caution should be taken when taking these because they are secreted in human milk.
Vitamins and minerals depleted by H2 Blocker Zantac® –
Calcium, Folic Acid, Iron, Vitamin B12, Vitamin D, Zinc.
Adverse reactions reported in adult studies by Proton Pump Inhibitors (Prevacid®, Prilosec®, Aciphex®, Nexium®, Protonix®) –
Fatigue, dizziness, headache, abdominal pain, diarrhea, nausea, hypergastrinoma, rash, tinnitus, proteinuria
Vitamins and minerals depleted by Proton Pump Inhibitors (Prevacid®, Prilosec® Aciphex®, Nexium®, Protonix®) –
Blocks Vitamin B12 (critical for digestion, absorption, energy, stress-relief, and concentration
Adverse reactions by Antacids (Mylanta®) –
Dehydration, stomach cramps, constipation, decreased bowel motility, fecal impaction, hemorrhoids,
nausea, vomiting; Mylanta® also contains aluminum, a neurotoxin.
Vitamins and minerals depleted by Antacids (Mylanta®) –
Calcium, Phosphorous (both critical for bone growth)
Case study of how simple dietary changes can reverse reflux –
35 year-old nursing mother with extremely fussy 6 month-old boy. Baby was projectile vomiting, spitting up constantly, and had noxious gas, abnormal stools, and bloating. The mother already had a reflux prescription for her son, but called me first. The woman ate relatively healthy, except she unknowingly was eating all the wrong foods for her and the baby. She was eating a lot of dairy, bread, and soy products. She also was not eating enough protein. We told her to avoid dairy, bread, and soy completely for several weeks to see if it made a difference. She balanced her meals by always eating a protein or healthy fat with carbohydrates. We upped her protein intake. Within two days, there was a noticeable reduction in all symptoms. After a week, there were no symptoms.
I would never say to avoid reflux meds completely, especially if a severe medical situation arises. If nothing has worked dietarily, and you need short-term relief, reflux meds may be warranted. But many cases can be reversed with optimal diet and nutrient instruction. Many infants grow out of colic/reflux at three months as their digestive system becomes more mature.
The current commonality of long-term use and doctor’s over-prescribing reflux medications warrants immediate attention. Health Professionals, Government Officials, and most importantly parents, must take notice, educate themselves, and take action to minimize the threat of negative consequences for the long-term health of our youths.
© Copyright 2005 Nutritional Concepts, Inc.
For more information, you can purchase my Reverse Reflux in Your Child Action Plan for $4.95 at nutritionalconcepts.com.
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