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Flashcards in GOR vs GORD Deck (10):
1

GOR vs GORD

GOR:
- = gastrooeseophageal reflux
- Passage of gastric contents into oesophagus

GORD = GOR with complications

2

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

3

What is the natural history of GOR?

Benign - self-limiting

4

What illness is GOR associated with?

ALTE - not SIDS

5

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

6

What are the possible complications with GOR?

• oesophagitis 
• failure to thrive 
• aspiration

7

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)

8

In which populations is GORD more frequent in?

- Cerebral palsy
- T21
- CF
- Upper GI malformations (tracheooesophageal fistula, hiatus hernia, pyloric stenosis)
- secondary to cow milk / soy protein intolerance  

9

What are some features that point towards GORD and not GOR?

• More likely if > 4 times per day
• Vomiting
• pronounced irritability with arching
• refusal to feed
• weight loss or crossing percentiles
• haematemesis
• chronic cough,  wheeze
• apnoeas

10

Mx of GORD in paeds

○ Consider acid suppressant therapy: H2 receptor antags /PPIs
○ NB - antacids not recommended bc of ingredients
• Nissen fundoplication used if all else failed