9: Peds Gastroesophageal Reflux Flashcards
1
Q
What is a common term for infants with GER?
A
Happy spitters
2
Q
What 2 medications are 1st-line if medication is needed in GER?
A
- H2 Blockers (-tidines):
- Cimetidine
- Ranitidine
- Famotidine
- Nizatidine
- PPIs (-prazoles):
- Omeprazole (with sodium bicarb)
- Lansoprazole
- Pantoprazole
- Rabeprazole
- Esomeprezole
3
Q
T/F GER may be a secondary sign of another condition.
A
True
4
Q
What is the difference between GER and GERD?
A
- GER is reflux of gastric content through lower esophageal sphincter without irritation or injury to the esophagus. It is usually physiological.
- GERD is pathological secondary to complications and causes injury.
5
Q
What 5 diagnostics should be considered in GER?
A
R/O pyloric stenosis or other causes of vomiting:
- Upper GI
- Gastric emptying scan if needed
- Endoscopy
- Esophageal pH monitoring
- Electrical impedance measures
6
Q
Abnormal behavior and posturing of head and trunk after feeds.
A
Sandifer Syndrome
7
Q
What is the etiology of GER?
A
- Multifactorial and unclear
- Increased abd pressure
- Delayed gastric emptying (allergy?)
- Hormonal factors
- Neurologic control
- Age
- Alterations in motility
8
Q
When is a PPI better than an H2 blocker?
A
Severe/erosive esophagitis
9
Q
7 nonpharm treatments for GER.
A
- Hypollaegenic formula
- Small, frequent meals
- Upright after meals
- Thickening agents (rice cereal)
- Elevation of bed > age 1
- Avoidance of chocolate, caffeine, high fat foods, spicy foods, alcohol, bedtime snacks
- Weight loss in overweight children
10
Q
T/F Infants with GER may have a hx of frequent respiratory infx (AOM, sinusitis, pneumonia).
A
True
11
Q
What are the 3 classifications of GER?
A
- Physiologic (infrequent)
- Functional
- Pathologic
12
Q
Why would baclofen be considered in GER?
A
- Increase LES pressure
- Improve gastric emptying
- Not much proven efficacy
