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30 - Gastrointestinal reflux

Published online by Cambridge University Press:  10 December 2009

Patti J. Thureen
By
Sudarshan Rao Jadcherla
Edited by
William W. Hay
Patti J. Thureen
Affiliation:
University of Colorado at Denver and Health Sciences Center
Sudarshan Rao Jadcherla
Affiliation:
Section of Neonatology, Columbus Children's Hospital, and Department of Pediatrics, The Ohio State University School of Medicine and Public Health, Columbus, OH
William W. Hay
Affiliation:
University of Colorado at Denver and Health Sciences Center
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Summary

Gastrointestinal reflux (GIR) is a common problem in high-risk neonates and young infants, and is due to the retrograde flow of gastrointestinal contents from distal bowel into the more proximal region. This includes (1) duodeno-gastric reflux (DGR) when duodenal contents move into the stomach; (2) duodeno-gastroesophageal reflux (DGER) when duodenal and gastric contents move into the esophagus; and (3) the more common and well studied, gastroesophageal reflux (GER) when gastric contents reflux into the esophagus or supra-esophageal structures. The symptoms of the disease resulting from GIR in neonates and infants are protean. There are many excellent reviews on GER in adults and children. There is considerable lack of information on GIR in neonates or high-risk infants. In this chapter we will discuss the three entities of GIR, specifically the applied physiology, pathology, clinical presentation, and available treatment options pertinent to young infants.

Significance of GIR

Gastric emptying, duodenal clearance and intestinal transit in healthy neonates are aboral, despite feeding frequently, suggesting that DGR and DGER are uncommon. However, both these conditions can occur in ill infants. On the other hand, GER is more common in neonates and young infants, and can be physiological if the infant is thriving well and has absence of symptoms inducible by gastric contents. Variable forms of GER, manifesting as regurgitation with movement of gastric contents into the mouth, can occur two or more times a day in nearly 50% of 2-month-old infants, but it occurs in only 1% of 1-year-old infants, thus indicating that regurgitation usually has spontaneous resolution and that changes in dietary habits may alter its course.

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Neonatal Nutrition and Metabolism , pp. 445 - 453
Publisher: Cambridge University Press
Print publication year: 2006

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  • Gastrointestinal reflux
    • By Sudarshan Rao Jadcherla, Section of Neonatology, Columbus Children's Hospital, and Department of Pediatrics, The Ohio State University School of Medicine and Public Health, Columbus, OH
  • Patti J. Thureen, University of Colorado at Denver and Health Sciences Center
  • Edited by William W. Hay, University of Colorado at Denver and Health Sciences Center
  • Book: Neonatal Nutrition and Metabolism
  • Online publication: 10 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544712.031
Available formats
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To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

  • Gastrointestinal reflux
    • By Sudarshan Rao Jadcherla, Section of Neonatology, Columbus Children's Hospital, and Department of Pediatrics, The Ohio State University School of Medicine and Public Health, Columbus, OH
  • Patti J. Thureen, University of Colorado at Denver and Health Sciences Center
  • Edited by William W. Hay, University of Colorado at Denver and Health Sciences Center
  • Book: Neonatal Nutrition and Metabolism
  • Online publication: 10 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544712.031
Available formats
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To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Gastrointestinal reflux
    • By Sudarshan Rao Jadcherla, Section of Neonatology, Columbus Children's Hospital, and Department of Pediatrics, The Ohio State University School of Medicine and Public Health, Columbus, OH
  • Patti J. Thureen, University of Colorado at Denver and Health Sciences Center
  • Edited by William W. Hay, University of Colorado at Denver and Health Sciences Center
  • Book: Neonatal Nutrition and Metabolism
  • Online publication: 10 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544712.031
Available formats
×