GERD stands
for Gastroesophageal Reflux Disease. This occurs when you have a
backflow of acid from your stomach enter the esophagus. This
causes the "burn" from the term "heartburn," and can damage the
esophagus lining. Reflux is considered a disease when it is severe
enough to impact a patient's life and/or damage the esophagus.
Additionally, it can cause asthma, sore throats, difficulty in
swallowing, and can dissolve the enamel of the teeth. In the U.S.
alone, approximately 7 million people suffer from GERD.
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GERD Symptoms
Adults:
Heartburn, regurgitation of gastric acid or sour contents into
mouth, chest pain, difficult or painful swallowing, chest pain, frequent
hiccups, asthma.
Babies:
Frequent hiccups, crying, shows signs of hunger but
only eats small amounts due to pain, screaming hungry but turning away
from the breast, difficulty swallowing, frequent spit-ups, irritability,
persistent crying, fussing after feedings, arching back, stiffening
legs, asthma, hoarseness, stretching body, bad breath, poor weight gain,
wheezing, coughing, moments with no breathing, hiccuping sounds as if
the child is not breathing for a moment, diagnosis of colic, difficulty
sleeping, diarrhea, choking.
Cause
GERD is caused by reflux of the
stomach acid into the esophagus. The sphincter (or "gate") that
keeps the lower end of the esophagus closed will relax, allowing acid to
enter the esophagus.
Diagnosis
Upper GI:The child must drink a chalky substance
called barium, which will display as white on
anx-ray.
Video
Floroscopic Swallow Study: This
test is done to rule out or verify aspiration and/or swallow problems.
It is similar to the upper GI, but is focused
on the mouth and throat. Aspeech pathologist or occupational
therapist may review the test and evaluate
the swallow function. A variety of textures
and liquid consistencies are given for a full evaluation.
Prolonged
Intraesophageal pH Monitoring: This is a 24 hour pH
probe and is the most sensitive test for
reflux. A small plastic tube is passed
through a nostril and into the esophagus. It is taped securely to the
nose, and attached to a portable recording device. After a day of
recording, the results are analyzed, so that associations can be made
between the episodes of reflux and the symptoms.
Upper
GI Endoscopy & Esophageal
Biopsy: The
child is sedated, and a flexible plastic tube with a tiny camera on the
end is inserted through the mouth, down the throat, and into the
esophagus and stomach. During this test, the esophageal and stomach
walls are carefully inspected for signs of inflammation. Biopsies,
which are pinhead-sized pieces of the surface tissue layer,
are inspected under the microscope with
immediate results for hiatal hernias, ulcers, and inflammation.
Biopsy results may take several days, depending on the facility.
Treatment of Gastroesophageal Reflux
Treatment for reflux usually begins with an antacid. Avoid
antacids that contain aluminum, choosing the form that contains magnesium
instead. Prescriptions for reflux may include an H2RA drug, which
decreases production of acid in the stomach. Prokinetic agents are used to
speed stomach digestion and to tighten the "gate" from the stomach to the
esophagus. Examples of these are Bethanechol and Metoclopramide.
Please
click herefor some tips on
managing a baby with reflux.
