Tips for children’s health: For a better care of children by Unknown

Author:Unknown
Language: eng
Format: epub
Publisher: Jamil zogheib
Published: 2015-06-08T16:00:00+00:00

Ø If there are neurological symptoms: drowsiness or deficit Ø If the child refuses to drink and/or there is little urine output

Ø If the child has stomach ache

Gastroesophageal reflux disease (GERD) in children

R

egurgitation, reflux: Many babies face these troubles in the first few months of life. This results in a passive return of immediately swallowed food. So it has nothing to do with vomiting.

W

hat is the cause of this problem? How does it present itself? What are the solutions? Should the baby take anti reflux milk formula? ... Here is some advice.

1-Regurgitation versus gastroesophageal reflux

It is a problem of frequent confusion. Approximately 25 to 40% of children ex- perience problems of regurgitation. This physiological gastro-esophageal reflux often worries the parents. Moreover, it is considered to be the second reason for consultation of pediatrics for babies.

Regurgitation is benign. It occurs right after meals, and is related to immaturity of the digestive system of the infant. It has no effect on the weight curve or appetite. This phenomenon is relatively common before the age of 2 months, and tends to disappear around the 9th month, when the child begins to stand up.

Conversely, gastro-esophageal reflux disease has abundant spit or projectile vomiting, occurring at any time (even during sleep) and can cause or aggravate underlying pathologies: laryngitis, asthma and chronic bronchitis... These vomiting episodes may be accompanied by the presence of streaks of blood. The child is sometimes crying a lot, refuses to eat and has a stagnant weight, due to esophagitis (inflammation of the esophagus).

However, do not confuse regurgitation with vomiting!

Regurgitation is a simple return, without effort, of undigested milk, while when vomiting, the food is rejected with effort after the beginning of digestion.

2- Keys to be understood

The esophagus, a long muscular tube, allows the food flow from the mouth to the stomach. At the junction of the stomach and the esophagus there is a sphincter, which opens at the arrival of the bolus and then closes. We talk of gastroesophageal reflux when, due to a failure of the sphincter, gastric acid content goes back into the esophagus.

This is the immaturity of the lower esophageal sphincter, which is often the cause. It happens that this “one-way valve” is not fully formed and does not play its role in preventing the contents of the stomach to go back during digestion. With time, this acid reflux can irritate the esophagus mucosa, causing esophagitis, which is particularly painful. This is explained by the existence of anatomical and functional predispositions in babies:

- A decrease in the basal tone of the lower esophageal sphincter leads to episodes of inappropriate relaxation of this sphincter.

- A delay in gastric emptying.

The nature of GERD in children is almost exclusively acid bile reflux is exceptional.

Some children have an increased risk of gastro -esophageal reflux and a high risk of complications. It is especially the case of premature babies, of twins, of children with family history of GERD and children with neurological disorders or abnormalities of the esophagus.

3- Clinical Presentation

The clinical characteristics of GERD form the basis of its diagnosis.

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