GERD vs GER in pediatrics Prof Hatem Hussein

Pediatric Gastroesophageal Reflux Disease (GERD)
What is GERD?
Gastroesophageal reflux disease is a chronic digestive disorder that is caused by the abnormal flow of gastric acid from the stomach into the esophagus.
Gastroesophageal refers to the stomach and esophagus, and reflux means to flow back or return. Gastroesophageal reflux (GER) is the return of acidic stomach juices, or food and fluids, back up into the esophagus.
GER is very common in infants, though it can occur at any age. It is the most common cause of vomiting during infancy.
When Renesha came to Children's at 19-years-old, she weighed 286 pounds. Now, after her treatment through the Obesity Program, she's a self-proclaimed "health freak," encouraging her family and friends to work out and eat healthy with her.
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What causes GERD?
GERD is often the result of conditions that affect the lower esophageal sphincter (LES). The LES, a muscle located at the bottom of the esophagus, opens to let food into the stomach and closes to keep food in the stomach. When this muscle relaxes too often or for too long, acid refluxes back into the esophagus, causing vomiting or heartburn.
Everyone has gastroesophageal reflux from time to time. If you have ever burped and had an acid taste in your mouth, you have had reflux. The lower esophageal sphincter occasionally relaxes at inopportune times, and usually, all your child will experience is a bad taste in the mouth or a mild, momentary feeling of heartburn.
Infants are more likely to experience weakness of the lower esophageal sphincter (LES), causing it to relax when it should remain shut. As food or milk is digesting, the LES opens and allows the stomach contents to go back up the esophagus. Sometimes, the stomach contents go all the way up the esophagus and the infant or child vomits. Other times, the stomach contents only go part of the way up the esophagus, causing heartburn, breathing problems, or, possibly, no symptoms at all.
Some foods seem to affect the muscle tone of the lower esophageal sphincter, allowing it to stay open longer than normal. These include, but are not limited to, the following:
Chocolate
Peppermint
High-fat foods
Other foods increase acid production in the stomach, including:
Citrus foods
Tomatoes and tomato sauces
Why is GERD a concern?
Some infants and children who have GER may not vomit, but may still have stomach contents move up the esophagus and spill over into the windpipe (the trachea), which can cause asthma and/or pneumonia.
Infants and children with GERD who vomit frequently may not gain weight and grow normally. Inflammation (esophagitis) or ulcers (sores) can form in the esophagus due to contact with stomach acid. These can be painful and also may bleed, leading to anemia (too few red blood cells in the bloodstream). Esophageal narrowing (stricture) and Barrett's esophagus (abnormal cells in the esophageal lining) are long-term complications from inflammation that are seen in adults.
What are the symptoms of GERD?
Heartburn, also called acid indigestion, is the most common symptom of GERD. Heartburn is described as a burning chest pain that begins behind the breastbone and moves upward to the neck and throat. It can last as long as two hours and is often worse after eating. Lying down or bending over after a meal can also contribute to heartburn. Most children younger than 12 years of age who are diagnosed with GERD will experience a dry cough, asthma symptoms, or trouble swallowing, instead of classic heartburn.
The following are other common symptoms of GERD. However, each child may experience symptoms differently. Symptoms may include:
Belching
Refusal to eat
Stomachache
Fussiness around mealtimes
Frequent vomiting
Hiccups
Gagging
Choking
Frequent cough
Coughing fits at night
Wheezing
Frequent upper respiratory infections (colds)
Frequent ear infections
Rattling in the chest
Frequent sore throat in the morning
Sour taste in the mouth
The symptoms of GERD may resemble other conditions or medical problems. Consult your child's doctor for a diagnosis.

[@reemsaleh6193]

الشرح المصري دايما الاقرب الى قلبي تنباسو والله

[@yomnaali4797]

Excellent lecture 👌 👏 👍

[@KidzclinicTV]

محاضرة ممتازة جدا من استاذنا الكبير ا.د حاتم حسين ربنا يبارك فيه ويزيده من العلم

[@drmohamedezz]

thanks