Microbiologic studies generally are not necessaryĢ% to 3% of infants in developed countries Sudden onset, often short duration of symptomsĬlinical dehydration (weight loss, prolonged capillary refill time, skin turgor) Neurodevelopmental delay or other disordersĠ.5 to 1.9 illnesses per person annually in developed countriesĢ.5 illnesses per year in 2- to 3-year-olds 5 illnesses per year in those attending day care Sandifer syndrome (neck tilting in infants) Recurrent laryngitis, pneumonia, sinusitis, or otitis mediaĪpnea or cyanosis (i.e., apparent life-threatening event) Onset of vomiting after six months of ageĪbdominal tenderness or distension, hepatosplenomegaly Regurgitation and/or vomiting beyond 18 months of age Symptoms are not bothersome to the infant or childĬhest pain, epigastric pain, nonlocalized abdominal pain Poor weight gain or weight loss, failure to thrive Signs and symptoms requiring further evaluation Surgical treatment is available, but should be considered only when medical therapy is unsuccessful or is not tolerated. They are effective in infants, based on low-quality evidence, and in children and adolescents, based on low- to moderate-quality evidence. Histamine H 2 receptor antagonists and proton pump inhibitors are the principal medical therapies for GERD. Lifestyle changes to treat reflux in children and adolescents include sleeping position changes weight loss and avoiding smoking, alcohol, and late evening meals. Reflux in infants may be treated with body position changes while awake, lower-volume feedings, thickening agents (i.e., rice cereal), antiregurgitant formula, extensively hydrolyzed or amino acid formulas, and, in breastfed infants, eliminating cow's milk and eggs from the mother's diet. In infants, most regurgitation resolves by 12 months of age and does not require treatment. Diagnostic tests, such as endoscopy, barium study, multiple intraluminal impedance, and pH monitoring, are reserved for when there are atypical symptoms, warning signs, doubts about the diagnosis, or suspected complications or treatment failure. The diagnoses of gastroesophageal reflux and GERD are based on the history and physical examination. Gastroesophageal reflux disease (GERD) is reflux that causes troublesome symptoms or leads to medical complications. It is a normal physiologic process that occurs throughout the day in infants and less often in children and adolescents. The Anti-Reflux Surgery involves wrapping the stomach around the oesophagus to improve the barrier function of the Lower Oesophageal Sphincter (LOS).Gastroesophageal reflux is defined as the passage of stomach contents into the esophagus with or without accompanied regurgitation (spitting up) and vomiting. Stretta is a non-surgical treatment which treats the underlying cause of GORD, a weak muscle between the stomach and the oesophagus, filling the gap between medications and surgery.įor patients who suffer from chronic heartburn, acid reflux and are considering a surgical intervention, Stretta may be an optimal and less invasive option which improves the quality of life. Stretta is a safe and effective outpatient procedure for patients who prefer a less invasive therapy. The following drugs work by decreasing acid production: These medications provide symptomatic relief from acid reflux but are generally required for the lifetime of the patient. Eliminate spicy or fatty foods, and citrus or tomato products.Sleep with the head of the bed elevated.Treatment options for acid reflux often depend on the severity of the condition and may include the following:Ĭhanges in lifestyle may relieve acid reflux symptoms in some patients.
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