Paeds: GORD Flashcards Preview

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Flashcards in Paeds: GORD Deck (13):
1

S&S

Irritability
Vomiting
Feeding difficulties
Weight loss
Heartburn (older children)

2

RF

- Cerebral palsy
- Newborns with bronchopulmonary dysplasia (chronic lung disease of prematurity)
- Surgery for oesophageal atresia or diaphragmatic hernia

3

Pathophysiology

1. Abnormal: Acidity in oesophagus from reflux of stomach contents >4% of a 24-h period
2. Immaturity of lower oesophageal sphincter leading to episodes of inappropriate relaxation
3. Short intra-abdo length of oesophagus

4

Often resolves spontaneously due to

Maturation of LOS
Upright position
More solids in diet

5

Diagnosis

1. Mild and uncomplicated - diagnosis clinically
2. 24-H oesophageal pH monitoring
3. Contrast studies of UGIT - Exclude anatomical abnormalities.
4. Endoscopy
5. Oesophageal biopsy

6

Treatment

- SMA thick and easy
Thickening agents e.g. carobel
3. Positioning upright post feeds
4. H2 antagonists
5. PPI
6. Domperidone
7. Surgery

7

H2 antagonist

Ranitidine

8

PPI

omeprazole

9

Domperidone function

Enhances gastric emptying

10

Surgery type?

Fundoplication (fundus of stomach wrapped around intra-abdominal oesophagus)

11

Complications

- Failure to thrive
- Feeding problems
- Oesophagitis
- Pulmonary aspiration leading to bronchitis/pneumonia
- Sandifers syndrome
- Apnoea
- Apparent life-threatening events (ALTEs) or sudden infant death syndrome (SIDs)

12

Oesophagitis S&S

Pain
Bleeding
Iron deficiency
Peptic stricture

13

Sandifers syndrome

Dystonic movements of head and neck

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