GORD

Question 1

define

Answer 1

= involuntary passage of gastric contents into oesophagus

Question 2

aetiology of GOR

Answer 2

GOR can be normal finding in infants
- nearly all resolve spontaneously by 12 mo due to
» maturation of Lower oesphageal sphincter
» upright posture
» most solids in diet

Question 3

etiology of GORD

Answer 3

(GOR becoms GORD when reflux freq + duration produces s/s) due to:

> > delay in neuro maturation eg. preterm infants
neuro impairments eg. cerebral palsy
excessive freq spontaneous reduction in sphinter pressure eg. coughing/crying/defecation

Question 4

what diseases are associated with GORD (ddx)

Answer 4

cows milk protein intolerance
oesophageal atresia
hiatus hernia

Question 5

s/s

Answer 5

> > > > typically develops before 8 weeks
vomiting/regurgitation following feeds

may also get:
general symptoms: feeding avoidance or feeding w/ discomfot, irritability (discomfort on acid digestion), failure to thrive)

GI symptoms: difficulty/pain on swallowing, freq vomiting hours after feeds, hematemesis, abdo/gastric pain

resp: apnoea, intermittent stridor, recurrent chest infections

Question 6

pathophys

Answer 6

aetology causes listed above affect angle of His (the acute angle between gastric cardia and distal oesphagus)

Question 7

ix

Answer 7

DIAGNOSIS IS USUALLY CLINICAL

1. 24hr monitoring of oesphagus - calculates reflux index ie. time @ which lower oesphagus ph is 4)
2. impedence testing- uses electrical currents to more sensitively test small changes in ph
3. contrast studies- upper git to exclude other anatomical abnormalities
4. endoscopy- confirms oesphagitis, biopsies of lower oesophagus/fundus/duodenum

Question 8

complications

Answer 8

distress
failure to thrive [from severe vomiting]
aspiration can lead to recurrent pneumonia
frequent otitis media
in older children dental erosion may occur