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Query: UMLS:C0017168 (gastroesophageal reflux disease)
 11,783 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A controlled, prospective comparison of the use of the infant seat versus prone, head-elevated positioning in a harness was undertaken in 15 infants with gastroesophageal reflux. pH monitoring of the distal esophagus demonstrated less reflux in the harness than in the seat (P less than 0.001) during 19 pairs of two-hour postprandial trials. This difference was the result of both fewer episodes (P less than 0.001) and briefer episodes (P less than 0.05). Prone-elevated positioning in the harness described is superior to positioning in an infant seat in the treatment of gastroesophageal reflux in infants younger than 6 months.
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PMID:Positioning for prevention of infant gastroesophageal reflux. 662 12

Based on results of epidemiological studies, dorsal or lateral sleeping positions are now recommanded in the prevention of sudden infant death syndrome (SIDS). This raises an ethical question about the attitude towards the ventral positioning therapy for gastroesophageal reflux (GOR). The consensus conference considers that the ventral position should only be recommanded in GOR when the benefit appears to outweigh the risk of SIDS that it induces. The conference proposes that for infants with simple uncomplicated reflux, sleeping in the prone position should not be introduced in the first line treatment. Prone positioning should be restricted to complicated cases resistant to dietary and medical measures.
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PMID:[Sleeping position, prevention of sudden death syndrome and gastroesophageal reflux]. 888 8

Gastroesophageal reflux (GER) is a frequently encountered problem in infancy; it commonly resolves spontaneously by 12 months of age. Caregivers are challenged to discriminate between physiologic GER and the much less common and more serious condition of pathologic gastroesophageal reflux disease (GERD). Pathologic GERD may require more extensive clinical evaluation and necessitate treatment. GERD may be primary or secondary; secondary GERD is associated with a number of genetic syndromes, chromosomal abnormalities, birth defects, or a host of neurologic conditions frequently seen in the newborn intensive care unit. This article reviews the unique anatomic, physiologic, developmental, and nutritional vulnerabilities of infants that make them susceptible to GER and GERD. The North American Society of Pediatric Gastroenterology and Nutrition have recently developed a comprehensive evidence-based clinical practice guideline that structures the diagnostic approach and treatment option in infants with suspected and confirmed GERD. These guidelines provide clear definitions of GER and GERD to aid the clinician in distinguishing between the 2 conditions. They emphasize the use of history and physical examination and discuss the indications for the use of other diagnostic procedures, such as upper gastrointestinal studies, nuclear medicine scintiscan, esophagogastroduodenoscopy with biopsy, and esophageal pH probe monitoring. Management of GERD begins with a nonpharmacologic approach; the emphasis is on positioning, a trial of a hypoallergenic formula, and thickening of feedings. When these measures fail to control symptoms, a trial of either histamine(2) antagonists or a proton pump inhibitor may be indicated. Finally, surgical treatment may be needed if all other management measures fail. New sleep recommendations for infants with GERD are now consistent with the American Academy of Pediatrics' standard recommendations. Prone sleep positioning is only considered in unusual cases, where the risk of death and complications from GERD outweighs the potential increased risk of sudden infant death syndrome (SIDS). The nursing care of infants with GER and GERD, as well as relevant issues for parent education and support, are reviewed and are essential elements in managing this common condition.
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PMID:Discerning differences: gastroesophageal reflux and gastroesophageal reflux disease in infants. 1536 16

Gastroesophageal reflux (GER) is a common physiologic phenomenon in preterm infants. Many infants remain asymptomatic, and the diagnosis of GER is difficult since clinical signs and symptoms are nonspecific. Diagnosis can also be difficult due to technical limitations. None of the currently available agents has been proven to prevent regurgitation. The efficacy and safety of gastroesophageal reflux disease (GERD) therapy have not been studied systematically in preterm infants. Therefore, clinicians must consider the risks and benefits of therapy. Preventive measures should be the firstline intervention. Prone, head upward and left-side positioning may reduce symptoms, but infants must be discharged home in the supine position. Thickening of feeds may be harmful in preterm infants. Frequent small-amount or continuous-drip feeding, short-term trial of hypoallergenic formula and probiotics are among the proposed treatments. Infants with severe symptoms and those who do not respond to the conservative and medical treatment need further diagnostic evaluation and very rarely a Nissen fundoplication.
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PMID:Gastroesophageal reflux (GER) in preterms: current dilemmas and unresolved problems in diagnosis and treatment. 2369 80