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Gastro-esophageal Reflux: Spitting and Possetting in a Neonate

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Abstract

Gastro-esophageal reflux (GER) is a common occurrence in newborns and a cause of anxiety to most parents. This physiological process needs to be closely differentiated from pathological reflux. The clinical signs in infants are generally non-specific which makes the distinction difficult. The diagnostic options in infants are limited, have low sensitivity and not readily available. Treatment of GER is challenging both for the clinician and family. The mainstay of therapy involves use of conservative modalities with limited use of pharmacological agents and surgical methods. This review aims to amalgamate evidence based guidelines to our current clinical practice.

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References

  1. Pediatric Gastro-esophageal reflux clinical practice guidelines: joint recommendations of the North American Society for Pediatric Gastroenterology Hepatology and Nutrition (NASPGHAN) and the European society for Pediatric Gastroenterology Hepatology and Nutrition (ESPGHAN). J Pediatr Gastroent Nutr. 2009;49:498–547.

    Article  Google Scholar 

  2. Goldani HAS, Nunes DLA, Ferreira CT. Managing gastroesophageal reflux disease in children: role of endoscopy. World J Gastrointest Endosc. 2012;4:339–46.

    Article  PubMed Central  PubMed  Google Scholar 

  3. Xl L, Wong KY. Gastroesophageal reflux disease in children. Hong Kong Med J. 2012;18:421–8.

    Google Scholar 

  4. Kultursay N. Gastro-esophageal reflux in preterms: Current dilemmas and unresolved problems in diagnosis and treatment. Turk J Pediatr. 2012;54:561–9.

    PubMed  Google Scholar 

  5. Lightdale J, Gremse D. Gastro-esophageal reflux: management guidance for practitioners. Pediatrics. 2013;131:e1684–95.

    Article  PubMed  Google Scholar 

  6. De S, Rajeshwari K, Kalra KK, Gondal R, Malhotra V, Mittal SK. Gastroesophageal reflux in infants and children in north India. Trop Gastroenterol. 2001;22:99–102.

    CAS  PubMed  Google Scholar 

  7. Solana García MJ, López-Herce Cid J, Sánchez SC. Gastroesophageal reflux in critically ill children. ISRN Gastroenterol. 2013;2013:824320.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Lopez-Alonso M, Moya MJ, Cabo JA, Ribas J, del Carmen Maclas M, Silny J, et al. Twenty-four-hour esophageal impedance- pH monitoring in healthy preterm neonates: rate and characteristics of acid, weakly acidic and weakly alkaline gastro-esophageal reflux. Pediatrics. 2006;118:e299–308.

  9. Armstrong K, Previtera N, McCallum R. Medicalizing normality? Management of irritability in babies. J Pediatr Chid Health. 2000;36:301–5.

    Article  CAS  Google Scholar 

  10. Aggarwal S, Mittal SK, Kalra KK. Infant gastro-esophageal reflux disease score: reproducibility and validity in a developing country. Trop Gastroentrol. 2004;25:94–8.

  11. Ferreria CT, de Carvalho E, Sdepanian VL, de Morais MB, Vieira MC, Silva LR. Gastro-esophageal reflux disease: exaggerations, evidence and clinical practice. J Pediatr (Rio J). 2013. pii: S0021–7557(13)00202–7.

  12. Puranik AD, Nair G, Aggarwal R, Bandyopadhyay A, Shinto A, Zade A. Scintigraphic scoring system for grading severity of gastro-esophageal reflux on 99 m Tc sulfur colloid gastro-esophageal reflux scintigraphy: a prospective study of 39 cases with pre and post treatment assessment. Indian J Nucl Med. 2013;28:79–84.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Kessing B, Smout A, Bredenoord A. Clinical applications of esophageal impedance monitoring and high resolution manometry. Curr Gastroenterol Rep. 2012;14:197–205.

    Article  PubMed Central  PubMed  Google Scholar 

  14. Czinn SJ, Blanchard S. Gastro-esophageal reflux disease in neonates and infants- when and how to treat. Pediatr Drugs. 2013;15:19–27.

    Article  Google Scholar 

  15. Neu M, Corwin E, Marcheggiani-Howard C. A review of nonsurgical treatment for the symptom of irritability in infants with GERD. J Spec Pediatr Nurs. 2012;17:177–92.

    Article  PubMed Central  PubMed  Google Scholar 

  16. Arikan D, Apl H, Gozum S, Orbak Z, Cifci EK. Effectiveness of massage, sucrose solution, herbal tea or hydrolysed formula in the treatment of infant colic. J Clin Nurs. 2008;17:1754–61.

    Article  PubMed  Google Scholar 

  17. Vander Pol RJ, Smits MJ, Van Wijk MP, Omari TI, Tabbers MM, Benninga MA. Efficacy of proton pump inhibitors in children with gastro-esophageal reflux disease: a systematic review. Pediatrics. 2011;127:925–35.

    Article  Google Scholar 

  18. Corvaglia L, Martini S, Aceti A, Arcuri S, Rossini R, Faldella G. Nonpharmacological management of gastro-esophageal reflux in preterm infants. Biomed Res Int. 2013;2013:141967.

    Article  PubMed Central  PubMed  Google Scholar 

  19. Tighe MP, Afzal NA, Bevan A, Beattie RM. Current pharmacological management of gastro-esophageal reflux in children: an evidence based systematic review. Pediatr Drugs. 2009;11:185–202.

    Article  Google Scholar 

  20. Canani RB, Cirillo P, Roggero P, Romano C, Malamisura B, Terrin G, et al; Working Group on Intestinal Infections of the Italian Society of Pediatric Gastroenterology, Hepatology and Nutrition (SIGENP). Therapy with gastric acidity inhibitors increases the risk of acute gastroenteritis and community acquired pneumonias in children. Pediatrics. 2006;117:e817–20.

  21. Maclennan S, Augood C, Cash-Gibson L, Logan S, Gilbert RE. Cisapride treatment for Gastro-esophageal reflux disease in children. Cochrane Database Syst Rev. 2010;14:CD002300.

  22. Lee WS, Beattie RM, Meadows N, Walker-Smith JA. Gastroesophageal reflux: clinical profiles and outcome. J Pediatr Child Health. 1999;35:568–71.

    Article  CAS  Google Scholar 

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Contributions

HC: Conceptualised, critically revised and approved the manuscript; AD: Drafted the manuscript; SA: Designed and critically revised the manuscript for intellectual content. HC will act as guarantor for this paper.

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Authors and Affiliations

  1. Neonatal Division, Department of Pediatrics, Safdarjung Hospital, New Delhi, 110029, India

    Harish Chellani, Aashima Dabas & Sugandha Arya

Authors
  1. Harish Chellani
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  2. Aashima Dabas
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  3. Sugandha Arya
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Correspondence to Harish Chellani.

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Chellani, H., Dabas, A. & Arya, S. Gastro-esophageal Reflux: Spitting and Possetting in a Neonate. Indian J Pediatr 82, 39–43 (2015). https://doi.org/10.1007/s12098-014-1535-z

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  • DOI: https://doi.org/10.1007/s12098-014-1535-z

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