GER - infants Flashcards
(6 cards)
key points GER infants
Gastro-oesophageal reflux disease (GORD) should be differentiated from physiological gastro-oesophageal reflux, which is common in healthy, thriving babies and does not require specific investigations or management
GORD is not a common cause of unexplained crying, irritability or distressed behaviour in otherwise healthy infants
Empiric use of acid suppression for unsettled infants is not effective and may cause harm
The natural history of GORD is of resolution with time; any therapy commenced should be reviewed regularly
EPID - GER infants
Gastro-oesophageal reflux:
is common, affecting at least 40% of infants
usually begins before 8 weeks of age, peaks at 4 months and resolves by 1 year of age in majority of cases
does not cause crying and irritability in healthy infants. Infant crying peaks at 6-8 weeks, and hence some babies with simple GOR may also be unsettled
rarely require investigations
can usually be managed with parental education, support and anticipatory guidance
There is insufficient evidence to support the diagnosis or management of “silent reflux”
GER vs GERD -peads
Gastro-oesophageal reflux disease is when GOR causes vomiting with:
refusal to feed
pronounced irritability with feeding
aspiration
chronic cough, wheeze
slow weight gain
haematemesis
Cow milk protein allergy vs GORD - peads
Cow milk protein allergy (CMPA) can present with similar symptoms to GORD
Blood and/or mucous in stool, chronic diarrhoea or atopic risk factors make this diagnosis more likely. See Flow Chart below.
red flags GER in peads
Symptoms
Vomiting that is bilious; has onset >6 months of age; or is consistent and forceful
Significant diarrhoea or constipation
Fever or lethargy
Signs
Abdominal rigidity
Hepatosplenomegaly
Bulging fontanelle and/or increasing head circumference
Mng GER infants
https://www.rch.org.au/clinicalguide/guideline_index/Gastrooesophageal_reflux_disease_in_infants/
