GORD

Question 1

What is GOR?

Answer 1

Gastrooesophogeal Reflux - passage of gastric contents into oesophagus

Question 2

What is the normal pattern of regurgitation in an infant over its first year of life?

Answer 2

Peaks at 4 months (2/3rds will have more than 1 episode/day)
Decreases between 6-7 months
Only 5% will have regurgitation at 12 months

Question 3

What is the difference between GOR and GORD?

Answer 3

GORD = GOR leading to complications

Question 4

Name 3 risk factors for GORD

Answer 4

Cerebral palsy, Down Syndrome, CF, upper GI malformations (TOF, OA, pyloric stenosis, hiatus hernia)

Question 5

What are the 3 complications of GORD?

Answer 5

Oesophagitis
Failure to thrive
Aspiration

Question 6

Name 5 symptoms of GORD

Answer 6

Vomiting with:
Irritability
Refusal to feed
Weight loss or regression
Haematemesis
Chronic cough or wheeze
Apnoeas

Question 7

If presented with a child who is vomiting, when should you start investigations/management?

Answer 7

Only if other symptoms of GORD are present

Question 8

If a child is vomiting and irritable, is it likely that they have GORD? What is an alternative?

Answer 8

Unlikely - more likely to be coincidental (crying and vomiting)

Question 9

Name 2 non-pharmacological interventions to improve GOR. What is something you should never suggest?

Answer 9

Prone position after feeding
Milk-thickening agents

Don’t suggest they change from breastmilk to formula!

Question 10

Name 3 potential Ix for a child with GORD

Answer 10

Barium meal
Scintography
Endoscopy
pH studies

Question 11

What is the main stay of treatment for a child with GORD? What is a potential surgical intervention?

Answer 11

Proton pump inhibitor (omeprazole). Fundoplication if really severe