Paeds: GORD

Question 1

S&S

Answer 1

Irritability
Vomiting
Feeding difficulties
Weight loss
Heartburn (older children)

Question 2

RF

Answer 2

• Cerebral palsy
• Newborns with bronchopulmonary dysplasia (chronic lung disease of prematurity)
• Surgery for oesophageal atresia or diaphragmatic hernia

Question 3

Pathophysiology

Answer 3

1. Abnormal: Acidity in oesophagus from reflux of stomach contents >4% of a 24-h period
2. Immaturity of lower oesophageal sphincter leading to episodes of inappropriate relaxation
3. Short intra-abdo length of oesophagus

Question 4

Often resolves spontaneously due to

Answer 4

Maturation of LOS
Upright position
More solids in diet

Question 5

Diagnosis

Answer 5

1. Mild and uncomplicated - diagnosis clinically
2. 24-H oesophageal pH monitoring
3. Contrast studies of UGIT - Exclude anatomical abnormalities.
4. Endoscopy
5. Oesophageal biopsy

Question 6

Treatment

Answer 6

- SMA thick and easy
Thickening agents e.g. carobel
3. Positioning upright post feeds
4. H2 antagonists
5. PPI
6. Domperidone
7. Surgery

Question 7

H2 antagonist

Answer 7

Ranitidine

Question 8

PPI

Answer 8

omeprazole

Question 9

Domperidone function

Answer 9

Enhances gastric emptying

Question 10

Surgery type?

Answer 10

Fundoplication (fundus of stomach wrapped around intra-abdominal oesophagus)

Question 11

Complications

Answer 11

• Failure to thrive
• Feeding problems
• Oesophagitis
• Pulmonary aspiration leading to bronchitis/pneumonia
• Sandifers syndrome
• Apnoea
• Apparent life-threatening events (ALTEs) or sudden infant death syndrome (SIDs)

Question 12

Oesophagitis S&S

Answer 12

Pain
Bleeding
Iron deficiency
Peptic stricture

Question 13

Sandifers syndrome

Answer 13

Dystonic movements of head and neck