The baby/child is given a white strawberry flavoured liquid to swallow. For babies this will be administered from a bottle, or through a nasal gastric tube if necessary. An X-ray is taken by a Radiologist (X-ray Doctor), which is projected on a video screen, and then analysed.
This investigation is positive in approximately 50 to 60 percent of babies/children who clinically suggest GOR (gastro-oesophageal Reflux). The examination may demonstrate reflux, the wave pattern in the oesophagus, and the rate of emptying of the stomach. Importantly, this investigation shows whether the anatomy of the oesophagus and stomach are normal and if the baby/child has a hiatus hernia.
Babies/children with GOR may not reflux during the period of the screening, producing a normal reading. A Barium Swallow is therefore not a very reliable test for reflux, as it is possible for a baby/child to have reflux but it not to be picked up by this investigation.
It is common for the Barium preparation to cause constipation, and it should not be left to harden in the bowel. Therefore a laxative may need to be used if constipation is, or becomes a problem. It is useful to take the baby/child’s favourite bottle or cup to administer the barium preparation, as this may make the procedure more acceptable to them.
This investigation involves 15 minutes under a general anaesthetic if the symptoms and signs suggest reflux oesophagitis. The endoscopist (the doctor who performs the endoscopy) is able to assess the degree of oesophagitis (inflammation in the oesophagus), and whether there are any problems in the stomach and duodenum. A biopsy (specimen of the oesophageal lining) may be taken for pathological examination.
Other conditions such as coeliac disease (gluten intolerance), food allergies, lactose and other sugar intolerances, helicobactor pylori etc. can also be diagnosed from appropriate biopsies taken during an endoscopy.
This investigation is also a very important step before surgery is considered.
A probe sensitive to pH changes (thus an index of acidity) is positioned in the oesophagus. This investigation demonstrates the presence, frequency and duration of reflux episodes. For accuracy of result, the probe is left in the oesophagus for 18 – 24 hours, and an X-ray needs to be taken once the probe is in place to confirm it is positioned accurately.
This is a good test for determining whether a baby/child has reflux or not, and the severity of the condition. Several types of readings are taken, but the most crucial one is the % of reflux over 24 hours. In general: – under 5% is normal, 5 – 10% is mild, 10 – 20% is moderate and over 20% is severe. However, the severity of the condition is no indication of treatment needed e.g. a baby/child with mild reflux may still need Omeprazole, whereas a baby/child with severe reflux may remain well controlled on Zantac.
Diagnosing GER in Children – http://www.medscape.com/viewarticle/742615?src=mp&spon=9 – “The measurement of pH is the predominant modality used to diagnose gastroesophageal reflux (GER) in children. However, pH monitoring provides only part of the answer with respect to whether a child has reflux episodes. Multichannel intraluminal impedance monitoring can measure acidic and nonacidic reflux episodes using pressure-sensing electrodes along the length of the probe.” I haven’t heard of impedance monitoring being used in New Zealand.
© Gastric Reflux Association for the Support of Parents/babies (GRASP) and Crying Over Spilt Milk Gastric Reflux Support Network New Zealand for Parents of Infants and Children Charitable Trust (GRSNNZ) 2004. Used, edited and added to by GRSNNZ with permission.
Page may be printed or reproduced for personal use of families, as long as copyright and Crying Over Spilt Milk‘s URL are included. It may not be copied to other websites or publications without permission and acknowledgement. This information (unedited) was also provided (by GRASP) to health professionals in New Zealand to use ” to continue to support and inform families with babies/children with Gastro-oesophageal Reflux.”
Hi. My boy is 6.5 wks. He started screaming at 3 wks. Became unsettled for periods of up to nearly 12hrs without sleep. He's been on formula as my milk never came in. He gets about 100-200 ml breastmilk /dy I pump. He started spilling/vomiting a lot at 4.5wks old.started losec 9 dys ago-frm GP. Saw paediatriciAn 4 dys ago and started amino acid formula to check for CMA. I feel things improved a bit about 4 dys after losec started. Also he seemed great once on th amino acid formula but thn yesterday was his old really bad self - fussed all day 10am-4pm thn really distressed n frantic 4-9pm. He's been ok today.i also started adding karicare thickener 2 dys ago. His first poo day after starting amino acid formula was soft n ok but I thnk he might b constipated with th thickener. He really had to push to get yesterday's out n was very sticky. Anyone else experience this? What do you do? I've heard lactulose and prune juice etc can make reflux/ wind worse. I thought about halving th amt thickener I'm using.also his vomiting better on th new formula I think but still occasional. He vomited Sunday night n mayb brought th losec up- could 1 missed dose like thts make him bad th next day like he was? Any opinions greatly appreciated
Please consider joining Gastric Reflux Support Network NZ for Parents of Infants and Children Charitable Trust for access to our Newsletters and Private Local and National Support Networks: http://www.reflux.cryingoverspiltmilk.co.nz/grsnnz-membership-confidentiality-agreement-form/ Membership is free, and this gives you opportunities to discuss gastric reflux related issues with others in a safe and confidential setting. If you have completed a membership form previously, but never received anything further, please message me (Roslyn Ballantyne at https://www.facebook.com/roslyn.ballantyne.rn ) or comment below. The membership sign-up had been a double opt-in with a confirmation email, but as some people have had trouble with this, I've now changed it to a single opt-in. (I do still need to process applications and add you manually to your Local Support Networks though.)
Gastric Reflux Support Network NZ for Parents of Infants & Children Charitable Trust Membership & Confidentiality Agreement Form / Newsletter Admin PageFirst NameLast nameEmailStreet AddressCity/TownAreaPostcodeDo you live in NZ?Country and Area if not NZHome Phone (include area code)Partner's NameE…
Hi I'm a bit confused. I filled out th membership form on th cryingspiltmilk main page. Do I need to do anything else? I see there's a forum somewhere else - kiwi health or something? Or do I just post n use this Facebook page? I'm thnking you hav th older site but most people jst use this Facebook page now yeah? Ta :) I hav a 6 wks old beautiful boy who has been in so much pain been breaking my heart but I'm jst getting things in motion now to help I thnk. Saw paediatriciAn few dys ago n hav started losec gaviscon mylanta and amino acid formula with karicare thickener
Hiya, I'm starting to introduce solids to my almost 6 month old and just wondering if there are any foods that any of you have found to be better than others and which ones to avoid? TIA. :-)
Other information here: http://www.lalecheleague.org.nz/news-a-events/lllnz-conference-2014/312-lllnz-50th-anniversary-conference-2014
Anyone want to help? I know you all have plenty to say. ;-)
And just in case you missed the post and the opportunity to help others through.........In five words, no more no less, share some inspirational advice to parents that are struggling with a newborn suffering from colic, reflux and inconsolable crying. If there are enough submissions I will post these on my website and perhaps in my book - Prevent and Remedy Colic, Reflux, Lactose and Dairy Overload Naturally - which is off to the proof readers this week!! http://www.naturalwinding.com/book/
A new story: http://www.cryingoverspiltmilk.co.nz/ryans-story-of-reflux-and-christinas-story-of-pnd/ Thank you, Christina.
I don’t really know where to begin with my story of Ryan and his reflux, and me with Post Natal Depression. I used to feel very sad thinking of all the precious time that was robbed from us. I loved Ryan from the moment I saw him, and he was a dream baby up until two weeks of age. ...
Hi my 7 week old, breastfed baby started showing signs of reflux recently so I went to the GP and was prescribed Gaviscon sachets. I'm having trouble giving it to her, but it seems to be working. She usually goes poos after every feed but since starting the Gaviscon (monday) she has only been once. She strains and cries. Not sure what i safe to give her to help as she is so young? Thanks
Hi there My 8 week old boy is formula fed and is now trialing gaviscon for his silent reflux, already I feel like it is making a difference but I am worried about the possible constipation the gaviscon may cause...how do you parents relieve constipation in young babies? I know about the cooled boiled water but are there any other remedies that are worth knowing about? Or tricks that can maybe help avoid constipation?
Hi, would you say it's a reflux symptom to bring up small vomits between feeds? Like an hour or so after eating? I keep being told that's normal, but it doesn't feel normal? My baby is only 4 weeks old though, so it's hard to me to tell what's normal and what isn't.
Hi, my 10 week old is trialling gaviscon to see if it helps with her (potential) reflux. She isnt a miserable baby, but she does scream if I put her down in the daytime, she has a persistent cough, a husky voice (this developed over the last week), and she spills even hours after a feed. Does this sound like reflux? If so, how do I get her to keep the gaviscon down? It says to give it to her after a feed, but she vomits straight after a feed...also is it worth going dairy free to see if this helps? Finding the spilling and coughing and husky voice quite upsetting, it must be horrible for her :(
Here is an amazing article about using probiotics and digestive enzymes to help with reflux. I only found this after I had my second reflux baby and he was 4 months old. Our first son had an endoscopy when he was 12months, which revealed extremely low digestive enzymes in his stomach. So when losec and ranitidine didn't provide much relief for our new baby, we presumed he was the same. We put him onto probiotics and enzymes and have had great results. Worth a read if you are interested. Feel free to message me for any more info (iv been researching it ever since!)
What I found to help! I am not claiming to cure or diagnose anything!
Good on you team for creating an awareness week and getting all of the publicity. So proud of those who have shared their stories. They have all had me in tears, partly because it triggers memories and partly because reading about those who have been without medical support just makes me so sad. Plunket nurses should be required to read about the symptoms of reflux and some real life stories as part of training. So should midwives actually.