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Is this the right treatment for food regurgitation?

Q: My one and a half year old baby, weighing 10 kgs, is suffering from a rare problem of food regurgitation. He takes a lot of time to swallow the food and keeps it in his mouth, until we force him to swallow. A specialist has diagonised this problem as Achalasia cardia. He has been through a barium swallow. Someone has suggested us to consult another hospital. They did a balloon dilatation surgery. We were told to put the baby on Ciza for one month, thrice a day before food. We did as we were told. When we went for the review, we were advised to continue Ciza, for the next 2 months. Our problem is we have not seen any difference in the baby's food intake even after the dilatation. Since the last 5 days he vomits once every day. Please help us.

A:The diagnosis had been made already and a surgery (dilatation) had been done. In my opinion, the concerned doctors had wisely taken the most conservative option of dilatation. I believe that this decision would have been taken after weighing out the pros and cons. You have mentioned that there is no change in the number of times of regurgitation and that you are giving Ciza continuously. I find that with all this regurgitation, the nutrition is not seriously impaired and the current weight is reasonably okay. Kindly continue Ciza or a similar drug, as prescribed by your doctor. There are certain other drugs which may relax the valve at the lower end of the food pipe - but they may not be appropriate for very young children. Ensure that the child does not sleep (lie down flat) immediately after food. The balloon dilatation may be repeated as and when necessary. Other surgical options are also available. But before undertaking such surgeries, your doctor will weigh out whether they are necessary. The question is not whether there are facilities are available in your city - but whether such surgeries are necessary at all. Go for periodical review by your doctor(s). If you want to, you may even go for a second opinion from another qualified specialist. This must be done ideally in person, with the child and with all the records. Nowadays, doctors welcome second opinions. and it will set your doubts at rest.

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