GORD

Question 1

Define GORD

Answer 1

content of the stomach relfx through the lower oesophageal sphincter into thte oesophagus throat and mouth

Question 2

why are babies prone to GORD

Answer 2

immaturitiy of the LOS

-allows stomach content to easily relfux into oesophagus
-normal for babies to reflux feeds and provided there are no additoinal syx or concerns about growth its fine

90% of babies sotp having reflux by 1 year

Question 3

signs of problematic GORD in a baby 6

Answer 3

chronic cough

hoarse cry

distress, crying or unsettled after feeding

reluctance to feed

pneumonia

poor weight gain

Question 4

syx of GORD in a child over 1 yo

Answer 4

similar to adults

heartburn

acid regurg

retrosternal or epigastric pain

blaoting

nocturnal cough

Question 5

possible causes of vomitiing in a baby 8

Answer 5

overfeeding

GORd

pyloric stenosis- projectile vomit

gastritis or gastroenteritis

appendicitis

infections like UTI,tonsillitis or meningitis

intestinal obsturction

bulimia

Question 6

red flag GI syx and their cause
-not keeping any feed down 2

Answer 6

pyloric stenosis or intestinal obstruction

Question 7

red flag GI syx and their cause
-projective or forceful vomit 2

Answer 7

pyloric stenosisi

intestinal obstruction

Question 8

red flag GI syx and their cause
bile stained viomti

Answer 8

intenstinal obstruction

Question 9

red flag GI syx and their cause
haematemesis or melaena 3

Answer 9

peptic ulcer

oesophagitis

varices

Question 10

red flag GI syx and their cause
abdominal distention 1

Answer 10

intestinal obstruction

Question 11

red flag GI syx and their cause
reduced consciousness, bulging fontanelle, neuro signs 2

Answer 11

meningitis

raised ICP

Question 12

red flag GI syx and their cause
respiraotry syx 1

Answer 12

aspiration with infection

Question 13

red flag GI syx and their cause
blood in stools 2

Answer 13

gastroenteritis

cows milk protein allergy

Question 14

red flag GI syx and their cause
signs of infectino 5

Answer 14

pneumonia
uti
tonsiliti
otitis
meningitis

Question 15

signs of a cows milk portein alergy in a child 4

Answer 15

rash

angioedema

other allergy signs

blood in stools

Question 16

simple managemnt of GORD 4

Answer 16

explanation reassurance practical advice

small, frequent meals

burping regularly to let milk settle

not over feeding

keeping baby upright after feed

Question 17

problematic GORD managemnt 3

Answer 17

Gaviscon mixed with feeds

thickened milk or formula s

PPIs (omeprazole)

Question 18

further investigations for sever GORD 2

Answer 18

barium meal

endoscopy

Question 19

managemnt of sever GORD

Answer 19

surgical fundoplication

-rarly requied or performed

Question 20

state a rare syndrome that is associated with GORD in children

Answer 20

Sandifers syndrome

Question 21

key features of sandifers syndrome 2

Answer 21

*usually neurologically intact

torticollis- forceful contraction of the neck muscles -> twisting of the neck

Dystonia- abnormal muscle contractions causing twisting movements, arching of the back and unusual postures

Question 22

overview of sandifers syndrome management

Answer 22

tends to resolve with treatment/improvement of the reflux

ALWAYS referrred to specalists as differentials includ infantile spasms and seizures