Is Reflux Overtreated and Overdiagnosed?
PAGER received a call from a reporter last Friday. The reporter talked to Jennifer Rackley and asked whether we think acid reflux is over diagnosed in young children. Apparently, she had interviewed a number of pediatric gastroenterologists who all shared this opinion. I've been hearing muttering about reflux being over diagnosed for the past several years. About three years ago, the comments and discussion came out in the open. I attended a session of the American Academy of Pediatrics where Judith Sondheimer, was updating pediatricians on the latest news in pediatric gasteroenterology. Dr. Sondheimer is a pediatric gastroenterologist in Denver and is also the editor of the Journal of Pediatric Gastroenterology and Nutrition. Dr. Sondheimer not only gave an update on reflux and several other gastrointestinal problems, she also talked at length about the over diagnosis of reflux. She was very disturbed by parents coming into her office insisting that their children need medications for reflux.
Dr. Sondheimer was also wary about public awareness campaigns educating parents about reflux in children. She was adamant that most babies who spit up are happy spitters and do not need to be treated. It seemed to be her belief that public awareness campaigns were leading parents to think that all children with even mild spitting up need treatment.
It was very interesting to hear what some gastroenterologists are thinking, but it was also disappointing that they seemed to blame the parents, the parent groups and the pharmaceutical companies. Yes, they have a few anecdotes about pushy parents, but our members have hundreds and hundreds of stories about having to fight for their child to get a diagnosis and treatment. A recent study published in the Journal of Pediatric Gastroenterology and Nutrition confirmed that parents often report a significant time delay and often have to go to several doctors.
Yes, many of our parents are frustrated. But, they are already frustrated when they call us. We strongly urge parents to work with their doctors. We urge them to be calm and we counsel them to bring charts that show how bad their child's reflux symptoms are. Many of our parents report very serious and even alarming symptoms in their children. We do not urge them to march into the doctor and demand treatment; we urge them to be good team members. We remind them that their job is to report symptoms and to be firm when they say the child has been in pain long enough. We help them learn how to be good observers and good advocates for their children.
PAGER Association has created National Tummy Ache Awareness Day to help parents learn the difference between regular tummy aches (and spitting up) and gastroesophageal reflux disease (GERD). On November 1, millions of children wake up with tummy aches from overindulging in Halloween candy. This is the perfect opportunity to talk to your child about whether their tummy feels this bad more than occasionally.
Much of our effort is spent on public awareness and education. The article in the Wall Street Journal will help children with reflux get a proper diagnosis.