Regurgitation in healthy and non healthy infants

Abstract

Uncomplicate regurgitation in otherwise healthy infants is not a disease. It consists of milk flow from mouth during or after feeding. Common causes include overfeeding, air swallowed during feeding, crying or coughing; physical exam is normal and weight gain is adequate. History and physical exam are diagnostic, and conservative therapy is recommended. Pathologic gastroesophageal reflux or gastroesophageal reflux disease refers to infants with regurgitation and vomiting associated with poor weight gain, respiratory symptoms, esophagitis. Reflux episodes occur most often during transient relaxations of the lower esophageal sphincter unaccompanied by swallowing, which permit gastric content to flow into the esophagus. A minor proportion of reflux episodes occurs when the lower esophageal sphincter fails to increase pressure during a sudden increase in intraabdominal pressure or when lower esophageal sphincter resting pressure is chronically reduced. Alterations in several protective mechanisms allow physiologic reflux to become gastroesophageal reflux disease; diagnostic approach is both clinical and instrumental: radiological series are useful to exclude anatomic abnormalities; pH-testing evaluates the quantity, frequency and duration of the acid reflux episodes; endoscopy and biopsy are performed in the case of esophagitis. Therapy with H2 receptor antagonists and proton pump inhibitors are suggested.

A cross-sectional study on prevalence of gastro esophageal reflux disease in regurgitant infant and children with evaluation of IGERQ score

“…Indrio et al reported GERD refers to infants with regurgitation and vomiting associated with poor weight gain. 8 These results were similar to the study of De et al, where 47% of children with IGERQ score >5 had inadequate weight gain. Orenstein study showed 26% of children with GERD had inadequate weight gain.…”

In Silico Identification of Plant miRNAs in Mammalian Breast Milk Exosomes – A Small Step Forward?

“…Currently, several known therapies use histamine H2 receptor antagonist to cure peptic ulcers (even relapses) and affect gastric acid secretion [46] . Treatments based on the HRH2 antagonist are also commonly used in gastro-esophageal reflux diseases in infants and children [47] , [48] . Among the putative plant miRNAs targets, one protein is also important for the therapeutics - nectin-4, alternatively referred to as poliovirus receptor-related protein 4 (PVRL4).…”

A Descriptive Study of Transient Neonatal Feeding Intolerance in a Tertiary Care Center in Turkey

“…Most of the other underlying conditions may be ruled out with a detailed history or laboratory evaluation. Overfeeding due to excessive feeding volumes is elicited by history and observation, whereas sepsis and pyelonephritis may present with poor clinical condition and a positive acute phase reactant (i.e., WBC, CRP and Interleukin‐6) (Hofer, Zacharias, Muller, & Resch, ; Indrio, Riezzo, Raimondi, Cavallo, & Francavilla, ). Obstruction in the gastrointestinal system manifests in the abdominal radiograph, whereas endocrine derangements and inborn errors of metabolism show abnormalities in the electrolyte panel, again with a poor clinical condition (Hryhorczuk & Lee, ; Nimkarn, Lin‐Su, & New, ; Piazza & Stoll, ).…”