GORD r Flashcards
what is GORD
contents of stomach reflux through LOS into oesophagus
why are babies likely to have gord
immature LOS
liquid diet
often lying down
how do you manage gord
usually self limiting and resolves
give feeding advice - thickeners, feed volumes, high calorie feeds etc
nutritional support
what do you do if the initial advice does not resolve the gord?
trial of cows milk protein free feed for 4 weeks
what are signs of problematic gord
chronic cough reluctance to feed distressed after feeding pneumonia poor weight gain sandifers syndrome
features of sandifers syndrome
torticollis - forceful contraction of neck muscles
dystonia - abnormal contractions causing twisting movements, arching of back, unusual posture
what can be used as a last resort to feed the child
NG tube
gastrostomy
medications for GORD
used for children with troublesome symptoms
H2 receptor blockers - ranitidine
PPIs - omeprazole
surgery for gord
nissen fundoplication
indications for surgery
if all other treatments fail
failure to thrive
aspiration
oesophagitis
additional tests if gord does not improve after 1 year
oesophageal pH study
endoscopy
video fluroscopy
barium swallow
