Reflux and Strictures Following Paediatric Surgery (OA/TOF)

Mr Nick Lansdale, Consultant Paediatric Surgeon at Royal Manchester Children’s Hospital, joined TOFS to share his insights on the subjects of reflux, dilatations, fundoplication and strictures. [Tip: Use the quick links below to jump to any part of the video]

00:00 Welcome

Reflux
01:28 What’s the best to manage reflux in babies and children?
09:42 Many members have asked whether reflux tends to improve as the child gets older?
11:11 “My child is taking high doses of daily medication but continues to have heartburn daily. Will this ever go away?”
13:28 Can you explain what silent reflux is and suggested treatments?
18:09 Can Gaviscon be used a preventative measure?

Vomiting
19:07 Do you have any suggestions as to what could be causing a 4 year-old OA/TOF to have frequent sickness episodes?

Strictures
22:30 What is a stricture and what are the signs of a dilatation/stretch being needed?
29:25 “My child’s food sometimes gets stuck, so whenever she drinks the fluid comes back up her nose. It's a total blockage. But other times she is fine. Is this a stricture forming and does she need a stretch?”
31:30 Many OA/TOF babies have issues when taking a bottle and can struggle with the flow. Does this improve with age and is there anything we can do in the meantime?
33:10 Do children grow out of needing dilatations? Is there anything that can be done to prevent strictures from reoccurring?
35:15 Are there non-surgical options to deal with recurring strictures?
37:14 Is it possible that reflux can become an issue or a stricture develop at a later age if a child has not been affected before?

Fundoplication:
39:00 Can you give us a brief explanation of what a fundoplication is and it’s benefits?
43:52 How long does a fundoplication usually last?

Diet
44:55 Can reflux be managed with diet? Can this lead to children coming off medication?
46:18 “My daughter is 14 now and has stopped taking her medication. She attributes any tummy aches to being lactose intolerant”. Do you have any suggestions that may help her?

Additional questions
49:55 What are the benefits vs the risks of taking PPIs (proton pump inhibitors) long term?
54:00 Can reflux resemble coffee-like colours?
54:25 Can long term use of Omeprazole affect bone density?
55:09 “My 3 year-old has had over 100 dilatations. Can these damage the oesophagus?”
56:26 What are the signs that a fundoplication has come undone?



About TOFS:
TOFS (Tracheo-Oesophageal Fistula Support) is a charity dedicated to improving the lives of people born with the OA/TOF condition and their carers. For over 40 years we have been helping people through the lifelong challenges that being born with OA/TOF (also known as EA/TEF in some parts of the world), VACTERL and associated conditions can bring.

Visit https://www.tofs.org.uk for more information and support.

Disclaimer: TOFS is not engaged in the practice of medicine, and any information provided is not intended or offered as medical advice and is absolutely not a substitute for the patient’s individual consultation with qualified healthcare professionals. Read more at: https://tofs.org.uk/terms-conditions/