Gastroesophageal reflux disease in Infant/Neonate
Alerts and Notices
Synopsis
It is unclear whether a higher frequency of GER events predisposes infants to GERD.
Patients with chronic cough and impaired mucosal clearance (eg, cystic fibrosis) and esophageal dysmotility (eg, esophageal atresia following repair) are predisposed to GERD.
Codes
ICD10CM:K21.00 – Gastro-esophageal reflux disease with esophagitis, without bleeding
K21.9 – Gastro-esophageal reflux disease without esophagitis
SNOMEDCT:
235595009 – Gastroesophageal reflux disease
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Tracheoesophageal fistula
- Peptic ulcer disease
- Gastritis
- Achalasia
- Esophageal spasm
- Gastroparesis
- Zollinger-Ellison syndrome
- Celiac disease
- Crohn disease
- Eosinophilic esophagitis or eosinophilic gastroenteritis
- Cow's milk protein allergy
- Pyloric stenosis
- Colic
- Esophageal ring or stricture
Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
References
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Last Reviewed:10/01/2018
Last Updated:01/16/2022
Last Updated:01/16/2022
Patient Information for Gastroesophageal reflux disease in Infant/Neonate
Overview
Gastroesophageal reflux disease (GERD) is a digestive disease. Patients with GERD experience stomach acid or stomach content moving up into the esophagus. This can be caused by malfunction of the esophageal sphincter, the opening between the stomach and the esophagus.Most people manage the symptoms on their own. However, sometimes medication or surgery is needed to reduce symptoms.
Who’s At Risk
Some risk factors for GERD are:- Obesity
- Pregnancy
- Dry mouth
- Smoking
- Diabetes
- Asthma
Signs & Symptoms
The symptoms of GERD are:- Heartburn or burning sensation in the chest
- Difficulty swallowing
- Indigestion or regurgitation of sour liquid (acid reflux)
- Chest pain, sometimes wheezing
- Dry cough, especially long-term cough
- Sore throat
Self-Care Guidelines
The following guidelines should be followed if you have GERD:- Avoid consuming foods and drinks that give you heartburn, called trigger foods, such as coffee, alcohol, spicy or acidic foods (citrus juice, tomato products), fatty foods, chocolate, peppermint, and onion
- Eat smaller meals
- Refrain from lying down until 3 hours after a meal
- Elevate your head in bed at least 8 inches
- Refrain from smoking
- Maintain a healthy weight
When to Seek Medical Care
If you experience severe symptoms of GERD, make an appointment with your health care provider.Treatments
The following over-the-counter medicines can help treat heartburn:- Antacids such as Maalox or Mylanta can provide quick relief
- Medication to reduce acid production including cimetidine (Tagamet HB) and famotidine (Pepcid AC) provide relief for up to 12 hours
- Lansoprazole (Prevacid 24 HR) is a proton-pump inhibitor that blocks acid production and allows the esophagus to heal
- Prescription strength H-2 receptor blockers such as cimetidine (Tagamet) or famotidine (Pepcid)
- Prescription strength proton-pump inhibitors such as esomeprazole (Nexium) or Iansoprazole (Prevacid) are well tolerated but long-term use can result in fractures and vitamin B12 deficiency
- Baclofen can decrease the occurrence of gastric reflux but has side effects of lethargy and confusion