Infant with GERD

Resolved question:
Several times a day my 5 month old arches back, shoves her hand in her mouth and turns her head to the side and cries in pain. She has silent reflux but it seems to be under control with Prevacid. Could it still be causing her pain or could this be something else? She does this all throughout the night as well. I have a video that shows it.

https://www.youtube.com/watch?v=KEDVVpGdkvc

Thanks!

Submitted: 4 Days
Category: Pediatrician

Expert:  Dr. Saptharishi L G replied 4 Days.

Dear Parent,

I have seen the video. The observed event could be due to underlying Gastro-esophageal Reflux disease (GERD). The above presentation is known as SANDIFER SYNDROME. However, there are a few parental observations that would point towards

GERD:
1. Occurs after feeding
2. Occurs more in the supine position/ night time
3. Relieved / Improves by using thickened feeds/ more frequent smaller volume feeds
4. Responds to proton pump inhibitors (which is Prevacid)

If your child fits into this pattern and still continues to have same problems, it is possible that his reflux may not be responding well to the ongoing therapy. We may need to add more drugs and try lifestyle modifications. Most kids do not require any surgical intervention, but if symptoms are severe and not-responsive to maximal medical therapy, it may be warranted.

You need to get him re-evaluated by his pediatric gastro-enterologist. Has he undergone tests yet? ( Upper GI Radio-isotope studies, pH monitoring, oesophageal manometry, etc).

Hope this helps, please feel free to discuss further.

Regards
Saptharishi L G


Dr. Saptharishi L G
DM (Pediatric Critical Care) Senior Resident
MBBS, MD (Pediatrics), PGDCRL
Division of Pediatric Critical Care
Dept. of Pediatrics
Advanced Pediatrics Center
Post-Graduate Institute of Medical Education & Research

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