Flashcards in GOR vs GORD Deck (10):
GOR vs GORD
- = gastrooeseophageal reflux
- Passage of gastric contents into oesophagus
GORD = GOR with complications
When is the peak incidence of GOR?
• peaks 4mo when ~67% of healthy term infants have > 1 daily episode of regurgitation
• at 12 months of age only 5% have symptoms
What is the natural history of GOR?
Benign - self-limiting
What illness is GOR associated with?
ALTE - not SIDS
What is the relationship between GOR and infant crying/irritability?
• No causal relationship proven
• "silent reflux" (reflux without vomiting) is an unlikely cause of infant crying
What are the possible complications with GOR?
• failure to thrive
What are some general mx measures for GOR?
• Reassure parents
• General measures
• Prone position after feeding (only in awake)
• Milk-thickening agents (eg rice cereal) reduce the number of episodes of vomiting but not the total time of oesophageal acidity
• Non-evidence based measures:
• avoid exposure to tobacco smoke
• avoid overfeeding
• avoid aerophagia (swallowing of excessive air): bottle horizontal, appropriate teat
• try smaller more frequent feeds (not <3 hourly)
In which populations is GORD more frequent in?
- Cerebral palsy
- Upper GI malformations (tracheooesophageal fistula, hiatus hernia, pyloric stenosis)
- secondary to cow milk / soy protein intolerance
What are some features that point towards GORD and not GOR?
• More likely if > 4 times per day
• pronounced irritability with arching
• refusal to feed
• weight loss or crossing percentiles
• chronic cough, wheeze