GOR vs GORD Flashcards
1
Q
GOR vs GORD
A
GOR:
- = gastrooeseophageal reflux
- Passage of gastric contents into oesophagus
GORD = GOR with complications
2
Q
When is the peak incidence of GOR?
A
- peaks 4mo when ~67% of healthy term infants have > 1 daily episode of regurgitation
- at 12 months of age only 5% have symptoms
3
Q
What is the natural history of GOR?
A
Benign - self-limiting
4
Q
What illness is GOR associated with?
A
ALTE - not SIDS
5
Q
What is the relationship between GOR and infant crying/irritability?
A
- No causal relationship proven
* “silent reflux” (reflux without vomiting) is an unlikely cause of infant crying
6
Q
What are the possible complications with GOR?
A
- oesophagitis
- failure to thrive
- aspiration
7
Q
What are some general mx measures for GOR?
A
- 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
Q
In which populations is GORD more frequent in?
A
- Cerebral palsy
- T21
- CF
- Upper GI malformations (tracheooesophageal fistula, hiatus hernia, pyloric stenosis)
- secondary to cow milk / soy protein intolerance
9
Q
What are some features that point towards GORD and not GOR?
A
- 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
Q
Mx of GORD in paeds
A
○ Consider acid suppressant therapy: H2 receptor antags /PPIs
○ NB - antacids not recommended bc of ingredients
• Nissen fundoplication used if all else failed
