QUESTION 1

My 9-year old daughter often complains of stomach cramps. Sometimes, the pain even shoots up to her chest and she complains of a burning feeling. I’ve brought her to a paediatrition before and she was prescribed probiotics. She was alright for about a month but now she’s complaining of the same symptoms again. Is this considered a gastric problem? I have Barrett’s oesophagus. Is that something that can be passed on to her?

Tang Li San
 

ANSWER:

Dear Li San,
Eva’s symptoms suggest that she has gastroesophageal reflux disease. The burning sensation that she feels can be caused by stomach juices moving back up her oesophagus (the tube connecting the mouth to the stomach). The acidic nature of these juices causes her to feel the burning sensation and over a long period of time, the constant exposure of the lower oesophagus to these juices will cause the cells lining the oesophagus to change. This change is described as Barrett’s oesophagus. Barrett’s oesophagus is associated with cancer and thus should be treated.

Eva needs to be seen by a paediatric gastroenterologist. She will need to undergo a series of tests to confirm the diagnosis of gastroesophageal reflux or oesophagitis. It is also useful to do a breath test to determine if she has a germ called helicobacter pylori present in her stomach which can aggrevate her symptoms. Once a diagnosis is made, she will need to be treated with the appropriate medications.

– Dr Lim Kwang Hsien

QUESTION 2

My son was diagnosis with Tethered Spinal Cord and Imperforate Anus. My gynae was not able to detect it during my pregnancy stage. Question: 1. Was it because I was an obese mum even ultrasound can't see it? 2. What causes my baby to have this major problem in his development? 3. What are his chances of being normal?

Ernie Haslina Zainal
 

ANSWER:

Dear Ernie,
The spinal cord connects your brain to the rest of your body. It normally floats in a fluid filled column within your backbone. Tethered Spinal Cord refers to a condition where the spinal cord does not float freely due to its attachment to an immovable structure such as the bone, a tumour or the skin over the spine. Unfortunately, it is difficult to diagnose this condition during your antenatal ultrasounds unless it is associated with a large skin or bone defect such as spinal bifida. Often, tethered spinal cord is diagnosed only after birth when your doctor notices some abnormality over the backbone such as a deep dimple, a swelling, a tuft of hair, or a bone defect. An MRI or ultrasound scan will then be performed to confirm the diagnosis.

The majority of the causes of tethered spinal cord remains unknown. However, we know that folic acid supplementation especially during the first trimester of pregnancy can prevent spinal bifida.

Imperforated anus is often diagnosed only after your child is born. Sometimes it is associated with other birth abnormalities such as spine, kidney, heart, bone and oesopnageal problems.

Ernie needs to be fully assessed by your paediatrician, a paediatric surgeon and a neurosurgeon. It is important to determine the severity of his tethered spinal cord and imperforated anus. He will also need to be screened for any other abnormalities that may be associated with both these conditions. His long-term prognosis will depend on the severity of his tethered cord and how badly his spinal cord is affected.

You might like to contact support groups such as club rainbow (www.clubrainbow.org) where you can meet parents of older children with similar problems.

– Dr Lim Kwang Hsien

QUESTION 3

My daughter is 9 years old and I noticed that she tends to have pain at her knee cap or lower joints and, within the next 1 to 2 days, she recovers automatically. She drinks and eats well and we feed her fruits every day. Can you please advise on the likely causes of the above?

Jessie Lim
 

ANSWER:

Dear Jessie,

Some children may experience such pain and they are referred to as growing pains. This pain is harmless and will disappear as Vanessa grows older. Some warning signs that you should look out for are knee or bone swelling, fever, limping and if there is more than one joint involved. Do bring her to see your doctor if she has any of these signs. You may also want to do a simple x-ray of her knee to rule out any major bone abnormalities.

– Dr Lim Kwang Hsien