1 / 10

Gastroesophageal reflux

Gastroesophageal reflux. Definition : Retrograde flow from stomach into oesophagus Does not have to present at mouth. Maturation aspects. Oesophagus clearance mechanisms "Physiological reflux" Most resolve spontaneously by 1 - 4 yrs. Iatrogenic causes of reflux. Gavage feeding and tubes.

renjiro
Download Presentation

Gastroesophageal reflux

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Gastroesophageal reflux • Definition: Retrograde flow from stomach into oesophagus Does not have to present at mouth

  2. Maturation aspects • Oesophagus clearance mechanisms • "Physiological reflux" • Most resolve spontaneously by 1 - 4 yrs

  3. Iatrogenic causes of reflux • Gavage feeding and tubes

  4. Problematic reflux incidence • 1 in 300 to 1000 children • 90% before 6 weeks age • Untreated, 10% complications

  5. Predisposition • Cerebral palsy • Tubes in seriously ill patients

  6. Defective LES Motility Abnormal neural control of LES Transient Lower Oes. Sphinct. relaxation Gastric distension GER Hiatus Hernia Oesophagitis

  7. Mode of presentation I Simple regurgitation, thriving Vast majority No treatment Regurgitation with failure to thrive Loss of nutrients

  8. Mode of presentation II Regurgitation with respiratory symptoms Recurrent pneumonia Persistent cough Wheezing Aspiration Vagus mediated Apnoea attacks Regurgitation with complication Anaemia from blood loss Stricture formation

  9. Diagnosis • Think of it • Upper GI barium series • Intra-oesophagus pH monitoring • Radio-nuclear scintigraphy "milk scan“ • Oesophagoscopy • Biopsy

  10. Management • Feeding and post-feeding position : prone, elevate • Change feeding pattern : frequent small feeds, thicken feeds : Nestargel/ gelatine • H2 receptor antagonists, proton pump inhibitors : antacid : reduce acid, heal oesophagitis • Prokinetic agents: cisapride (off the market), domperidone or metoclopramide before meals • Surgery

More Related