Williams- PEDS GI of Upper Tract Flashcards
passage of esophageal contents into esophagus that happens in 2/3 healthy infants
gastric esophageal reflux (GER)
painful passage of gastric contents into esophagus + complications such as projectile emesis and hematemesis
GERD
children should double their weight by _____ months
3 months
children should triple their weight by _____ months
12 months
____ is normal
GER
____ in infants is not a problem of excessive acid production
GER
the ____ has the same pressure in infants as it does in adults (10-30 mmHg)
LES
how to test for reflux
observation
pH testing
what to not do when testing for reflux
do not do upper GI study
what does this show
swallowing (pH doesnt drop)
what does this show
acidic reflux event (pH drops)
drop in pH
acid reflux episode
no pH drop
nonacid reflux episode
upper GI study is _______ justified to diagnose GER or GERD in infants
NOT
______ imaging is useful in the evaluation of vomiting (due to obstruction)
upper GI
how do H2 receptor antagonists work
inhibit acid secretion from H/K ATPase by blocking histamine
histamine
gastrin
Ach
all cause acid production (H/K ATPase stimulation)
these drugs physically attach to and block H/K ATPase
PPIs
_____ blocks gastrin, histamine
somatostatin
does not block vagal stimulation
somatostatin
2 main H2 blockers used in peds
Famotidine
Nizatidine
this suppresses acid production from 12-24 hours
PPIs
PPI that can be given in first few weeks/months of life
Omeprazole
this drug has no benefit in reducing crying or fussing and can be tied to increase risk for infection (due to decrease in acid production)
PPIs