They generally reserve it for treating cases in which they can’t control serious complications, such as esophageal bleeding or ulcers. If you already have diagnosed asthma, talk with your asthma physician (often an allergist/immunologist or a pulmonologist) about your symptoms.
Accordingly, a comprehensive evaluation of this phenomenon will likely require a bioelectrical impedance study (to identify nonacid reflux; see below) in conjunction with respiratory monitoring. Two major areas of controversy surround the relationship between gastroesophageal reflux and both apnea and otolaryngologic disease. Early studies appeared to demonstrate a link between gastroesophageal reflux and obstructive apnea (including an association with apparent life-threatening events [ALTEs]); however, recent investigations now suggest only a weak relationship between these disorders. Decreased gastric compliance is believed to lead to LES relaxation at lower intragastric volumes in infants. This aspect, in conjunction with abdominal wall muscle contraction (if it occurs during periods of LES relaxation) propels refluxate into the esophagus, with subsequent regurgitation.
The top portion of the stomach is wrapped around the esophagus, creating a tight band that reinforces the lower esophageal sphincter and greatly decreases reflux. Infants are more likely to experience weakness of the lower esophageal sphincter (LES), causing it to relax when it should remain shut. As food or milk is digesting, the LES opens and allows the stomach contents to go back up the esophagus. Sometimes, the stomach contents go all the way up the esophagus and the infant or child vomits.
Esophageal manometry. This test checks the strength of the esophagus muscles.
Children are also more likely to vomit or regurgitate, and might experience ear-nose-and-throat disorders. Sometimes younger children can’t express what’s bothering them, so they may become irritable. Side effects from medications that inhibit the production of stomach acid are uncommon. A small number of children may develop some sleepiness when they take Zantac, Pepcid, Axid, or Tagamet. .
Other babies vomit after having a normal amount of formula. These babies do better if they are constantly fed a small amount of milk. In both of these cases, tube feedings may be suggested.
In most infants the junction between the esophagus and stomach is “closed,” opening only to allow passage of formula or breast milk into the stomach or to allow the escape of swallowed air via burping. Gastroesophogeal reflux (GER) is the upward flow of stomach contents from the stomach into the esophagus (“swallowing tube”). While not required by its definition, these contents may continue from the esophagus into the pharynx (throat) and may be expelled from the mouth, and in infants, through the nostrils.
National Institutes of Health
See Table 3 for a list of common indications for surgical management. Antireflux procedures are usually performed to eradicate the reflux of gastric contents into the esophagus which should control GERD related symptoms, prevent complications, and permit adequate caloric intake to achieve growth . This is achieved by reestablishing the gastroesophageal barrier through creation of a partial or complete valve mechanism at the gastroesophageal junction (fundoplication) .
When these rings of muscle do not work properly, you may get heartburn or gastroesophageal reflux (GER). Chronic GER is often diagnosed as gastroesophageal reflux disease or GERD. The challenges that result from failed fundoplication have led to the implementation of alternative surgical management strategies for GERD . Many children who require gastrostomy placement often have coexistent GER .
In 1892, Osler first postulated a relationship between asthma and gastroesophageal reflux, manifested by a bidirectional cause-and-effect presentation. Accordingly, although gastroesophageal reflux may be involved in the etiology and progression of reactive airway disease, the asthmatic condition (in addition to antiasthmatic medications) may play a role in exacerbation of gastroesophageal reflux. Other complications noted in adults with gastroesophageal reflux, including Barrett esophagus and esophageal mucosal dysplasia, are uncommon in childhood. Signs and symptoms in older children include all of the above plus heartburn and a history of vomiting, regurgitation, unhealthy teeth, and halitosis. If changes at home do not help enough, the doctor may recommend medicines to treat GERD.