Gastroesophageal reflux (GER) is a very common condition in which stomach contents reflux back up into the esophagus. Gastric contents can be quite corrosive and irritating to the esophageal mucosa and symptoms, such as chest pain, heartburn, and nighttime cough, should not be ignored.
Case Study: 3-month-old with spit-ups
A 3-month-old baby boy presents to the office with his mom reporting significant spit-ups after every meal. Mom has been nursing exclusively and child has been growing and gaining weight normally until recently. Mom now reports fussiness with feeds and reports that he will throw up the majority of the milk up to an hour or two after feeds. His length and head circumference are normal, but his weight gain has slowed down over the past month.
GER is differentiated from GERD (gastroesophageal reflux disease) by the presence of co-morbid conditions such as chronic cough, recurrent ear or sinus infections, dental caries, weight loss in infants, and mucosal changes in adults. GERD is a risk factor for Barrett esophagus and cancer and thus should not be ignored. Medications can help neutralize acid or reduce acid production, promote gastric motility, or promote lower esophageal sphincter (LES) function. Dietary antigens (e.g. cow’s milk protein allergy) can affect gastric motility in infants, with removal resulting in significant improvement. In adults or nursing moms, reducing intake of spicy food, gas-promoting foods, dairy, coffee, and preserved foods may help alleviate symptoms. Other lifestyle measures, such as smoking cessation and weight loss may offer significant relief.