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Suggest Treatment For Vomiting In A Child

Posted on Mon, 9 Nov 2015

Question: Hello sir,
My son is 13 months old..he was born with arthrogryposis affecting lower limbs...his weight is 10.4 kgs..from the past 4 days he vomits after eating ..once or twice a day vomit is happening after food..we are giving him ondem child syrup 1.75 ml twice a day but still vomitting persists..there are no other complaints..hes active..taking food well..hydrated..no fever or loose motions..can you telme the cause and what should i do to stop his vomit?your help is most appreciated!

Answered by Dr. Pradeep Kumar Jain (1 hour later)

Brief Answer:
Most likely due to gastritis

Detailed Answer:
Hello

Thanks for the query
I can understand your concern.After going through the details I have concluded that the cause of vomiting is gastritis.
Ondem contains ondensetron an antiemetic and the dose is 0.1-0.2 mg/kg/dose.Each 5 ml of ondem contains 2 mg of ondensetron.For 10 kg the dose would be 3.5 ml two to three times a day depending on the severity.
Also give esomac XXXXXXX (esomeprazole, an acid reducing agent)once a day for 4-5 days.
I won't get worried if baby is active/playful, passing urine,well hydrated and there is no abdominal distension.
Consult your pediatrician if vomiting persists even after increasing the dose or if condition worsens for proper evaluation and management accordingly.

Please let me know if you have any more query.
Wishing for your child's speedy recovery.
Regards

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Pradeep Kumar Jain (2 days later)

What power is recommended for esomac sachet? 10 mg or 20 mg? Daily once? What after 4-5 days? Please reply asap..thanks

Answered by Dr. Pradeep Kumar Jain (7 minutes later)

Brief Answer:
Esomeprazole 10 mg once a day for this age

Detailed Answer:
Thanks for follow up

The dose of esomeprazole for this age is 10 mg once a day.
I would like to know if the symptoms are still there.
The most likely cause is gastritis and there should be improvement after 4-5 days of esomeprazole.
In case of improvement the esomeprazole should be given for 7-10 days for complete resolution.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Pradeep Kumar Jain (2 minutes later)

Sir is esomac for acid reflux? He is ok now but should we continue ondem syrup along with escomac for 10 days as well?

Answered by Dr. Pradeep Kumar Jain (21 minutes later)

Brief Answer:
It works both in acid reflux and gastritis

Detailed Answer:
Esomeprazole works in gastroesophageal reflux (reflux of acidic gastric content into food pipe causing discomfort and vomiting).
Gastritis may or may not be associated with gastroesophageal reflux and esomeprazole works in both the conditions.I don't think ondem is needed any more if there is no vomiting.
I would like to give esomac for 10 days.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Pradeep Kumar Jain (13 hours later)

Sir i would like to inform u that there is a shortage of esomac 10 mg granule here..i tried so many medicals but nobody has it..i found one medical but it has 20 mg grnules..can u telme a solution to it? I guess 20 mg is too high?

Answered by Dr. Pradeep Kumar Jain (2 hours later)

Brief Answer:
Half XXXXXXX of esomac or 1/2 tablet lansoprazole will do

Detailed Answer:
You can give half XXXXXXX of esomac granules or lansoprazole dispersible tablet half tablet daily.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Pradeep Kumar Jain (44 minutes later)

Thank you so much for ur prompt reply..we called his paediatrician today and he said to given ondem on sos basis ..and continue esomac but add syrup perinorm 1 ml thrice a day for 5 days..now i have no idea about this medicine..is it safe ? Cause inhave heard that there are many side effects..can it be taken along with esomac?please guide me cause i just talked to him on phone..didnt visit him..so i want to have a second opinion

Answered by Dr. Pradeep Kumar Jain (42 minutes later)

Brief Answer:
I don't think perinorm is needed

Detailed Answer:
I can understand your concern.You are right there are so many side effects of perinorm (metoclopramide).This is the reason I personally don't recommend unless it is very much required or patient is under direct observation.

As vomiting has subsided I don't think regular antiemetic is needed anymore.

I would like to give ondem as and when required as esomac/lansoprazole as suggested.
Even if your doctor recommends,it can be given with esomac as there is no interaction between the two.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Pradeep Kumar Jain (49 minutes later)

Thank you so much sir..so i shall continue esomac for 10 days or stop after 5 days if he is ok? Also i would like to ask u if there is any side effects of esomac or any risks of infection ?

Answered by Dr. Pradeep Kumar Jain (1 hour later)

Brief Answer:
Esomeprazole is a very safe medicine

Detailed Answer:
Esomeprazole is a very safe medicine and is approved for use in children.
If baby is asymptomatic and there is no further episodes of vomiting you can stop esomac after 5 days.
There is no significant side effect of esomac.

Thanks and regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Pradeep Kumar Jain (39 hours later)

Hello once again sir,
I gave only esomac to my child and after only 3 days of treatment i.e 10 mg one XXXXXXX each day he seems to be doing very very good..no vomitting..hes better now..your prescrobed medicone seems to suit him..now my question is 1.for a total complete cure how long shall i give it to him? 2.Does this thing comeback after we stop esomac or is it cured by compelting the course as prescribed by you? 3. Heard that esomac usage can cause GI infections and gi candidiasis? True? Even for auch a short use?? These are the 3 queries i had and thank you so much for helping my child because i wanted to ignore perinorm at all cost..

Answered by Dr. Pradeep Kumar Jain (44 minutes later)

Brief Answer:
7 days of esomac will be sufficient

Detailed Answer:
Happy to help.
It's good to know that baby is doing well.
7 days of esomac will be sufficient for complete resolution.The chance of recurrence is remote.
You are right, candidiasis is a known complication of esomac (any proton pump inhibitor)but only after prolonged use or in immunocompromised child.
I would like to give esomac for 7 days.

Take care.
Regards

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Pradeep Kumar Jain (2 days later)

Hello sir..today was the 5th day my son took esomac..i would like to tell you that since 4 days he was ok..no vomitting nothing..today morning also he was ok..but today after taking his afternoon lunch ..after few spoons of eating his lunch he vomitted it out..we again gave him food after 15-20 minutes..he ate properly and digested it..ondem was not used in these 5 days..now my question is ..can esomac make u nauseous and also cause vomitting? ..what shall i do if its not? Please help me

Answered by Dr. Pradeep Kumar Jain (1 hour later)

Brief Answer:
No need to worry for occasional vomiting

Detailed Answer:
I can understand your concern.
I won't get worried for occasional episode of vomiting.Esomac does not causes nausea or vomiting.
So just relax.Give esomac for next 2 days and then stop.
I hope he would recover completely.
Thanks and regards

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar