GERD, or gastroesophageal reflux disease, is one of the most frequently diagnosed conditions among infants. In its most severe form, the condition can cause food refusal, poor growth due to an inability to hold down food, breathing problems, and blood loss from the esophagus (caused by stomach acid burning the esophagus). Only a small portion of GERD cases are anywhere near this severe. What’s more, a new study suggests that the condition is being largely over-diagnosed.
According to study authors from the University of Michigan, symptoms of crying and spitting up are typical in young children. And they believe that these common symptoms in infants don’t always need a diagnosis because, based on their research, a diagnosis can lead to parents requesting medication, even if they are told that the medication may be ineffective at treating the symptoms. In turn, this leads to an overuse of medication – medication for which the long-term effects are not known, and medication that is now one of the most widely used medications among children under the age of one.
“The growing digestive systems of an infant can be finicky and cause the child to regurgitate. The discomfort can cause the infant to cry, but it is not necessarily a disease,” lead author of the study, Laura Scherer, assistant professor of psychological science in the College of Arts and Science at the University of Missouri told Health Canal.
“As doctors, we need to appreciate that the words we use when talking with patients and parents have power – the power to make a normal process seem like a disease,” senior author Beth Tarini, M.D., assistant professor of pediatrics at the University of Michigan’s C.S. Mott Children’s Hospital. “As pediatricians, our job is to make sick children healthy, not make healthy children sick.”
In their study, Tarini and colleagues surveyed parents coming into a Michigan pediatric clinic. They were asked how they would respond to a hypothetical clinical scenario in which their child was crying and spitting up excessively but was, otherwise, perfectly healthy. Half of the parents were randomly given a diagnosis of GERD for their child’s condition. The other half did not receive a diagnosis for the issue. All parents were told about medication frequently used for infantile GERD. However, only half of the parents were told that the medication may not be effective at treating the symptoms.
Based on parent responses, researchers found that parents who had been given a GERD diagnosis for their child were interested in receiving a prescription for their child’s condition, regardless of whether or not the doctor had discussed the possible ineffectiveness of the medication. However, parents that had not been given a diagnosis were only interested in the prescription when the doctor had failed to discuss the medication’s efficacy with them.
Scherer explains why this is a major problem for everyone involved, and why both physicians and parents need to be aware of the issue at hand.
“Parents can learn from this study that a disease label can make them want medication for their child, regardless of whether the drugs are effective or not. Parents should follow doctors’ advice, which sometimes means accepting a doctor’s explanation of why an infant’s crying and vomiting may be normal….Unnecessary use of medication is costly. Especially for families without insurance, the over-use of medication can be a needless expense. In addition, the long-term side effects of the medication frequently prescribed to children diagnosed with GERD have not been fully studied, although the medication has been correlated to slightly higher rates of pneumonia.”
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