One of the most common disorders in babies is vomiting. At least half of infants may vomit up some breast milk or formula after feeding. The baby does not feel discomfort during this time and there is no attempt to vomit. These simple vomitings are called "regurgitation" in medical language. It is a completely physiological event and may accompany burping and burping. As the child grows, this phenomenon gradually decreases and disappears.
Rumination is a condition seen from time to time in young babies and is the re-swallowing of breast milk or formula after it reaches the child's mouth. Sometimes it can also be seen in older children with intellectual disabilities. This may also be a sign of reflux.
“Gastroesophageal reflux” or abbreviated as “reflux” is the situation where the stomach contents come back into the esophagus. It is estimated that reflux disease occurs in an average of 8-10% of children. The most common symptom in babies is vomiting. Vomiting may occur during or after meals, or between meals or even while sleeping at night. Some babies may experience restlessness, fussiness, and coughing spells when lying down.
Since gastric fluid contains acid (HCl) and enzymes such as pepsin that digest food, its pH is acidic, and the esophagus is sensitive to these substances, reflux is a common problem in children. After a while, redness (esophagitis) and sores (ulcer) may occur in the esophagus. This situation causes symptoms such as loss of appetite, refusal to eat, and crying while feeding. Older children may complain of symptoms such as burning, sourness and boiling, as well as abdominal pain, burning and soreness behind the breastbone, and difficulty swallowing. Bad breath in the mouth is also one of the known symptoms.
Babies and children may present with bleeding without any complaints, or they may just have anemia, recurrent upper (pharyngitis, laryngitis, sinusitis, otitis media) and lower respiratory tract infections (bronchitis). , pneumonia) may also be the only symptom of reflux.
To diagnose reflux, it is necessary to first suspect the disease. If there are symptoms listed above and there is no other disease such as urinary tract infection that can cause vomiting in babies, reflux should first be considered and treatment should be recommended. Response to treatment will confirm the diagnosis of reflux. Get a response to treatment If the diagnosis of reflux is wanted to be confirmed due to prayer or atypical symptoms, the first tests to be performed are esophagoscopy (examination of the esophagus with a device called endoscope) and 24-hour pH examination of the esophagus. Endoscopic examination provides over 90% correct diagnosis when supported by a tiny tissue sample taken from the esophagus. It is a very simple process when done under appropriate conditions and by competent hands. pH examination of the esophagus requires a 24-hour hospital stay and has the disadvantage of not being able to detect alkaline and neutral reflux. Since radiological examination, which was performed very frequently in the past years, led to incorrect results at rates of nearly 50%, it is almost never used for initial diagnosis today. Scintigraphic examination is not the first method to be chosen because it is often not done properly and radioactive substances are used.
The first thing to do in the treatment of a child diagnosed with reflux is to elevate the head of the bed at least 30 degrees. It has been shown that laying babies in the left side position with their head higher is the best way to sleep.
It is possible to reduce reflux and vomiting by thickening the stomach contents. For this reason, AR (anti-reflux) foods with carob powder added can be used. On the other hand, chocolate, which reduces the pressure of the esophageal valve and increases stomach acid, is consumed by excessively fatty, spicy, hot and sour foods (chips, ketchup, mayonnaise, mustard, onion, garlic...), acidic, carbonated drinks (cola, ready-made fruit juices, sodas, It is recommended to ban or reduce alcohol consumption.
In order to reduce intra-abdominal pressure, not making children wear too tight clothes, not tightening belts too much, and losing weight for obese children can be among the precautions to be taken.
Drugs used by physicians. These are drugs that increase the pressure of the esophageal valve, facilitate gastric emptying, and neutralize or reduce stomach acid. However, these drugs must be used under the supervision of a physician, as treatment may be required for many years.
When there is no response to treatment and there are very serious reflux symptoms, surgical intervention is also included among the treatment options. However, such as apnea (temporary respiratory arrest) and the threat of sudden infant death If there are serious symptoms, stenosis develops, or in mentally disabled children, anti-reflux surgery is considered. It is not a treatment frequently applied to children today.
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