3.3 Gastro-Oesophageal Reflux Flashcards
What are signs of problematic reflux / GOR in a baby?
- chronic cough
- hoarse cry
- distress, crying or unsettled after feeding
- reluctance to feed
- pneumonia
- poor weight gain
(older than a year they may experience adult Sx: heartburn, acid regurg, nocturnal cough etc)
Some reflux is normal in babies, especially after large feeds. 90% will grow out of it by 1 yr.
8 causes of vomiting in children?
- overfeeding
- GOR
- pyloric stenosis (projectile)
- gastritis or gastroenteritis
- appendicitis
- UTI, tonsillitis, meningitis etc
- GI obstruction
- bulimia
Most vomiting / reflux in babies can be managed with small meal and regular burping.
What could you use in more problematic cases of GOR?
- giviscon mixed with feeds
- thicken milk formula (and specific reflux ones)
- ranitidine
- omeprazole
Rarely barium meal and endoscopy. Very rare surgical fundoplication (fundus round LOS).
not keeping any feed down is typically?
pyloric stenosis or intestinal obstruction
projectile or forceful vomiting is typically?
pyloric stenosis or intestinal obstruction
bile stained vomit is typically?
intestinal obstruction
haematemesis or malaenia is typically?
peptic ulcer, oesophagitis or varices
abdo distention and vomiting is typically?
obstruction
reduced consciousness, bulging fontanelle or neuro signs with vomiting is typically?
meningitis or raised ICP
resp symptoms and vomiting is typically?
aspiration and infection
blood in the stools and vomiting is typically?
gastroenteritis or cow’s milk protein allergy
vomiting and other signs of infection could be?
pneumonia, tonsillitis, otitis, meningitis
rash, angioedema and vomiting is typically?
cow’s milk protein allergy
torticollis and GOR is typically?
Sandifer’s syndrome
dystonia and GOR is typically?
Sandifer’s syndrome
