In spite of the fancy technology available to quantitate and qualitate reflux in kids, its identification remains what we call a clinical diagnosis. That means that as physicians we make the diagnosis by talking to patients. As pediatricians we depend on a parent's input to help round out the symptoms described by a child.
But many times when I directly ask parents about symptoms of heartburn they immediately dismiss the idea. They are, of course, their parents and tend to know what's going on. Usually.
Often we assume that an articulate eight-year-old is capable of recognizing a sensation like acid reflux as abnormal. But here's the problem: Children with chronic reflux often have come to understand their symptoms as part of who they are. They've had burning, fiery burps as long as they can remember - why complain if that's just the way it is?
So my one question to their child often surprises them. It is this: "Have you ever had a sour taste in your mouth like you're going to throw up but you don't throw up and instead you swallow it?" Sometimes I'll ask about hot or spicy burps. The money is in the response. Those kids who regularly experience this sensation immediately light up and connect with me in an unmistakable way. The feeling that they have always had has just been articulated. Those who don't experience reflux will look at me like I've lost my mind. Their response tells me a lot.
So while recognizing the subtle signs of reflux in a child requires experience and training, sometimes making the diagnosis can be as simple as asking a question.
Published On: January 14, 2008