Pediatrics for Parents - Infant vomiting - Brief Article
It’s normal for infants to spit up. But when spitting up becomes vomiting, and the vomiting becomes a regular thing, it may be time to worry. Most chronic infant vomiting is due to gastroesophageal reflux (GER). This condition causes contents of the stomach (gaster) to go back into the esophagus. This refluxing is often followed by vomiting.
In 85% of infants with GER, the symptoms disappear with conservative therapy–small frequent feedings thickened with rice cereal and elevating the baby’s head 30[degrees].
If this doesn’t work, the next step is various types of medications. Cimetadine (Tagamet) or liquid antacids to reduce the acidity in the stomach. Metoclopramide (Reglan) or other smooth muscle relaxants sometimes help.
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Many infants with GER have an upper GI–an x-ray study to confirm the diagnosis. The infants are given liquid barium to swallow while being x-rayed. The flow of the barium is followed to see how well it passes down the esophagus and into the stomach. It also shows if there’s any back flow of the barium from the stomach into the esophagus.
Doctors at Children’s Hospital, Boston, MA, recently reviewed records of 344 otherwise healthy infants who were seen by pediatric gastroenterologists (doctors who specialize in diseases and disorders of the digestive system) for GER. All the babies had an upper GI to help clarify the causes of their GER. Of the 344 infants, only 2 (0.6%) had any abnormalities other than GER.
One had a small hiatal hernia (a sliding of the stomach above the diaphragm) and another duodenal stenosis (a narrowing of the duodenum–the first part of the small intestine). Both of these abnormalities could have been found on other, non-x-ray, studies.
The doctors concluded that the upper GI has little to no role in evaluating chronic vomiting in babies. Other studies and treatments should be tried first.
Pediatric Radiology, 07/02.
COPYRIGHT 2003 Pediatrics for Parents, Inc.
COPYRIGHT 2008 Gale, Cengage Learning
