GERD: what, manifestations, testing, management, surgical mgmt.
- retrograde flow of gastric contents into the esophagus. Failure of the lower esophageal sphincter.
- Manifestations: spitting up, vomiting, weight loss, gagging, choking at the end of feedings(risk for aspiration), Resp problems, heartburn/irritability
Testing: Barium swallow, UGI series, Scintiscan, Flexible endoscopy
Management: change to soy formula, freq burping, small feedings (not over 30 min), elevate HOB, sleepingon left side, thicken formula with cereal, weight monitoring,Meds.
- Meds: H2 blockers-Zantac, Pepcid
- Prilosec-suppression of gastric acid
- Reglan-increase gastric emptying
Surgeries: Nissen fundoplication, G-tube