Stopping reflux

Infant refl ux occurs when food refl uxes from a baby's stomach, causing the baby to regurgitate.

Sometimes called gastrooesophageal refl ux disease (GORD), the condition is rarely serious and becomes less common as a baby gets older. It's unusual for infant refl ux to continue after 18 months. Refl ux occurs in healthy infants multiple times a day. As long as the infant is healthy, content and growing well, the refl ux is not a cause for concern. Rarely, infant refl ux can be a sign of a medical problem, such as an allergy, a blockage in the digestive system or GORD.

HOW INFANT REFLUX OCCURS

In infants, the ring of muscle between the esophagus and the stomach - the lower esophageal sphincter (LES) - is not yet fully mature. That allows stomach contents to fl ow backward. Eventually, the LES will open only when the baby swallows and will remain tightly closed at other times, keeping stomach contents where they belong.

The factors that contribute to infant refl ux are common in babies and often can't be avoided. These factors include: • Babies lying fl at most of the time • An almost completely liquid diet • Babies being born prematurely.

Occasionally, infant refl ux can be caused by more-serious conditions, such as: • GORD: The refl ux has enough acid to irritate and damage the lining of the esophagus. • Pyloric stenosis: A valve between the stomach and the small intestine is narrowed, preventing stomach contents from emptying into the small intestine. • Food intolerance: A protein in cow's milk is the most common trigger. • Eosinophilic oesophagitis: A certain type of white blood cell (eosinophil) builds up and injures the lining of the oesophagus.

Adco Myogel

COMPLICATIONS

Infant refl ux usually clears up by itself without causing problems for your baby.

If your baby has a more-serious condition such as GORD, he or she might show signs of poor growth. Some research indicates that babies who have frequent episodes of spitting up may be more likely to develop GORD during later childhood.

DIAGNOSIS

If testing includes: • Ultrasound: This imaging test can detect pyloric stenosis. • Lab tests: Blood and urine tests can help identify or rule out possible causes of recurring vomiting and poor weight gain. • Oesophageal pH monitoring: To measure the acidity in the baby’s oesophagus • X-rays: Can detect abnormalities in the digestive tract, such as an obstruction. Your baby may be given a contrast liquid (barium) from a bottle before the test. • Upper endoscopy: Tissue samples may be taken for analysis. For infants and children, endoscopy is usually done under general anesthesia.

SELF-MANAGEMENT

To minimise refl ux, the baby should be fed in an upright position. It is recommended to hold the baby in a sitting position for 30 minutes after feeding. Gravity can help stomach contents stay put. Be careful not to move the baby too much while the food is settling. Try smaller, morefrequent feedings, taking time to burp the baby. Frequent burps during and after feeding can keep air from building up in the baby's stomach. Most babies should be placed on their backs to sleep, even if they have refl ux.

STAYING NEUTRAL

The term ‘acid’ refl ux tends to imply that the stomach juice that refl uxes upward into the oesophagus causing symptoms is acid alone. However, the acid is the component of the stomach juice that causes irritation of the oesophagus and therefore, the symptoms.

Acid refl ux is just another term for gastroesophageal refl ux. The stomach juice that refl uxes contains many chemicals, of which acid is only one. Drugs that are used to treat gastrooesophageal refl ux disease (GORD) decrease or remove acid from the juices that are refl uxing, but the refl ux continues.

WHAT IS ACID REFLUX?

Acid refl ux and GORD are one and the same. These terms can be used interchangeably. However, for proper understanding, further explanation is needed.

The juices that are contained within the stomach include a wide array of chemicals. These include bile, enzymes and others. The stomach also produces acid that is mixed with these other chemicals. Therefore acid is not the only thing that is refl uxing, but the whole array of the chemicals in the stomach juice of which acid is only one.

ABOUT THE ACID

Heartburn is the most common symptom of acid refl ux. The thought pattern that follows is if the acid is removed from the stomach juice, the irritant is gone. Even though the refl ux of stomach juice is still occurring, symptoms do not happen.

This is exactly what happens when any of the medications for acid refl ux (or GORD) are taken. The drugs either neutralise the acid in the stomach juice or decrease its production by the stomach. Refl ux continues, but in the majority of situations symptoms are improved.

Notably, the actual cause of acid refl ux is not addressed by the medications. The dysfunctional valve at the end of the oesophagus is not changed at all.

WHAT ARE THE SYMPTOMS?

Common symptoms of acid refl ux are: Heartburn: A burning pain or discomfort that may move from your stomach to your abdomen or chest, or even up into your throat. Regurgitation: A sour or bitter-tasting acid backing up into your throat or mouth

Other symptoms of acid refl ux disease include: • Bloating • Bloody or black stools or bloody vomiting • Burping • Dysphagia - a narrowing of the oesophagus, which creates the sensation of food being stuck in the throat • Continuous hiccups • Nausea • Weight loss for no known reason • Wheezing, dry cough, hoarseness, or chronic sore throat.

Topzole

References available on request.