Investigations

BARIUM SWALLOW

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.


GASTROSCOPY/ENDOSCOPY

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.


pH PROBE

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.


OTHER

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.

baby colour large

© 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.”

  • We have a question from Sara now too.

  • Hi there! Im just wondering if anyone has gone down the line of bubs having to have an endoscopy and pH probe study because of reflux lasting too long? My bubs is 15 months and still on high doses of reflux meds and she gets so bad when we try to wean them down. Her Paediatrician has referred us for an Endoscopy +/- pH probe. Has anyone had this? If so, what was the outcome and did it even change their management? Thanks!

  • Hi everyone, Brylee has asked a question. Have a look at the posts to the page. Thanks for sharing your experiences in advance.

  • i keep getting an error message when trying to register?

  • Has anyone else had a major setback with reflux after their little one starts moving? I am feeling so emotionally drained and thought it was supposed to get better, he's now nearly one and we are back to square one

  • I've just hit SEND on the newsletter so if you are a member, you should receive it over the next 24 hours. I'm using MailChimp for the first time, so it will look a little different.
    If you aren't a member and would like to receive newsletters or join our local support groups, please complete a membership form: http://www.reflux.cryingoverspiltmilk.co.nz/grsnnz-membership-confidentiality-agreement-form/
    Membership is free. It has been great to see two to three new members every day since I fixed the form! :-)

    Gastric Reflux Support Network NZ for Parents of Infants & Children Charitable Trust Membership & Confidentiality Agreement Form / Newsletter Admin Page First Name Last name Email Street Address City/Town Area Auckland Bay of Plenty Canterbury Gisborne Hawkes Bay Marlborough Nelson Otago...

  • I've just discovered our membership form hasn't been working due to some unknown glitch and I've spent the last few hours getting it working again. I suspect this has been like this for a fortnight. So sorry anyone who has been trying to join. Remember membership is free and you can join in confidential chats with those in your local area.
    http://www.reflux.cryingoverspiltmilk.co.nz/grsnnz-membership-confidentiality-agreement-form/

    Gastric Reflux Support Network NZ for Parents of Infants & Children Charitable Trust Membership & Confidentiality Agreement Form / Newsletter Admin Page First Name Last name Email Street Address City/Town Area Auckland Bay of Plenty Canterbury Gisborne Hawkes Bay Marlborough Nelson Otago...

  • Another Post created on our website from the Tips on Coping thread from National Infant and Child Gastric Reflux Awareness Week. Thank you so much to those who contributed. I might just try and add this into the Help! Menu as well.

    The following is created from a thread during National Infant and Child Gastric Reflux Awareness Week on our Facebook Page https://www.facebook.com/hashtag/nationalinfantandchildgastricrefluxawarenessweek There were 38 comments with advice or tips on how parents coped with infants or children...

  • Story 2 from National Infant and Child Gastric Reflux Awareness Week transferred to our website for safekeeping. :-)

    Daughter number 3 was born in 2000, weighed 8lb, 6oz and fed well, but we escaped the maternity home earlier than with number 2 as she just wouldn’t settle at night easily. At eight days old, my husband found her grey and limp, but breathing. She went on to have prolonged apnoeas (cessation of...

  • National Infant and Child Gastric Reflux Awareness Week logo profile photos - The week finished 6th June. There are still a few people we've noticed with the logo as their profile picture. Can you please remove this now?

    Many thanks, for your support.

  • Thank you everyone who contributed to this. I think it will help others know that they are not alone in what they feel and experience. I also think it might be a great resource for health professionals.

    The following is created from a thread during National Infant and Child Gastric Reflux Awareness Week on our Facebook Page https://www.facebook.com/hashtag/nationalinfantandchildgastricrefluxawarenessweek It included words or short phrases that had something to do with what gastric reflux meant...

  • Who has seen National Infant and Child Gastric Reflux Awareness Week Posters in waiting rooms, reception areas, play centres, consult rooms or anywhere else?

    There was quite a number posted or delivered around NZ so we would love to hear if you spotted one.

    This is the printed A4 glossy poster that has our phone number and website address at the bottom - not the digital graphic. Draft preview here:

  • Gastric Reflux Support Network NZ shared their photo.

    Thank you so much to everyone that supported the Gastric Reflux Support Network NZ and promoted National Infant and Child Gastric Reflux Awareness Week by taking up the Challenge and using the logo as your PROFILE PICTURE on your PERSONAL PAGE.

    It was wonderful to see so many people doing this and I did lots of double-takes when visiting some pages as there were so many orange PROFILE PICTURES.

    I don't know about you, but I'm looking forward to next year and am already making plans. Hopefully, many of you will no longer be dealing with Infant Gastric Reflux, but feel free to come back between 31st May to 6th June and give others some hope that they will get through this difficult time. Put it in your diaries. :-)

    Best wishes for the year ahead,
    Roslyn Ballantyne, National Coordinator, Gastric Reflux Support Network NZ, National Infant and Child Gastric Reflux Awareness Week 2015!

    (Please note the National Infant and Child Gastric Reflux Awareness Week logo is copyright and may only be used with permission from GRSNNZ. It may be shared using the Facebook Share Function.)

    A Challenge to you ALL except we ask that you only do this on your Personal Profiles i.e. NO PAGES or GROUPS. National Infant and Child Gastric Reflux Awareness Week starts tomorrow and continues until 6th June. During this time GRSNNZ would love you to create Awareness by using this logo as your profile picture. Once you have set it as a profile picture please add a comment to the picture on your page and put the link to this Facebook Page and our Website: https://www.facebook.com/cryingoverspiltmilk and www.cryingoverspiltmilk.co.nz so others can find out more. (Please note the National Infant and Child Gastric Reflux Awareness Week logo is copyright and may only be used with permission from GRSNNZ. Permission is granted as above for the use of Personal Profile Pictures only. It may also be shared using the Facebook Share Function.) Example in the comment soon. Many thanks. GRSNNZ Committee.

  • I'm slowly copying over the Awareness Week happenings to the Crying Over Spilt Milk website so we don't lose them. You will also find some of last year's publicity and stories there. Here is Day 1.

    My first child definitely had very few, if no signs of gastric reflux. I can’t even remember her spilling much – mind you, she is 22 years old. Three years later we had another daughter, born 13 days late, who decided she should then enter the world in a rush. She became unsettled at about two...

  • Hi.

    Just wondering people's opinion or feedback on how they get their baby to sleep?
    My GP wants me to let my 5 month old 'cry it out' but I just don't think it's the best idea for him. At Present we feed him to sleep.

    Thanks

  • Gastric Reflux Support Network NZ shared Mum 2 Mum's photo.

    Just sharing this back to our timeline again as this was a perfect way to promote National Infant and Child Gastric Reflux Awareness Week.

    The logo and Awareness Week is not used to sell a product or promote the business.

    It links back to our website and Facebook page so that users can identify that the logo belongs to the Gastric Reflux Support Network NZ ,and seek support and information.

    Top points Mum 2 Mum.

    Today marks the first day of "National Infant and Child Gastric Reflux Awareness Week" - here at Mum 2 Mum we are not strangers to refluxy and spilly babies and we we know how hard it can be as parents some times. If you have any concerns about your infant or child's health or think they may be suffering from Gastric Reflux, please contact a healthcare professional - if you wish to learn more (from symptoms to real experiences), please take a look at the national gastric reflux support website: www.cryingoverspiltmilk.co.nz or check out Gastric Reflux Support Network NZ :)

  • Copyright: The National Infant and Child Gastric Reflux Awareness Week logo/graphic is copyright to Gastric Reflux Support Network New Zealand and may only be used with permission from GRSNNZ.

    During National Infant and Child Gastric Reflux Awareness Week 2015 the logo has been used without permission and in some cases to promote businesses.

    Crying Over Spilt Milk and Gastric Reflux Support Network New Zealand for Parents of Infants and Children Charitable Trust does NOT endorse any product, business, health professional or treatment as there is no one correct way to treat or parent our infants and children with gastric reflux.

  • Gastric Reflux Support Network NZ updated their cover photo.

  • #NationalInfantandChildGastricRefluxAwarenessWeek Story 5

    I just looked back and re-read the archived version of daughter number 3's story. This is the edited version of the end of it which might be useful for those dealing with Child Gastric Reflux

    At the time of writing this, she was almost four years. She was almost seven before she had her Nissen Fundoplication surgery so it was not something we rushed into.

    "We have just reduced and stopped her medication to determine if she still really needs it, and she may be referred for a surgical opinion if reflux continues to be a problem. She does seem to still have reflux though, and we wonder how long she will be able to stay off medication.

    Some of the ways she describes what she feels are: "my tummy is hot", "my tummy has sick in it" and "my tummy feels sore", "sick" or "unwell" as well as the obvious sounds of refluxing occurring and sore throats.

    I have never been happy about the thought of surgery to cure her reflux, but over the last few months and with all the research and reading of other's stories (both negative and positive) I at last feel peaceful about this possibility. Whatever happens now we know that reflux is likely to continue be part of her life, but that as she gets older she will be able to tell us more clearly what is happening."

    Written by Roz, Regional Coordinator for © Gastric Reflux Support Network New Zealand 25/01/2004.

    Roslyn Ballantyne, National Coordinator, Gastric Reflux Support Network

  • #NationalInfantandChildGastricRefluxAwarenessWeek
    Please share one piece of advice that has helped you cope (no medical advice).
    Remember national guidelines for sleep are on the back, flat and in their own space.

  • #NationalInfantandChildGastricRefluxAwarenessWeek
    Let's play a game.
    Put in a comment on this post a word or short phrase that has something to do with gastric reflux for you.
    And sign it with your relationship eg mum.
    Please keep it to one description per person as we will potentially have 100s of replies.

  • Gastric Reflux Support Network NZ created an event.

    Come and join us for morning tea to celebrate National Infant and Child Gastric Reflux Awareness Week in Christchurch. If you are not already a @[199074539208:274:Gastric Reflux Support Network NZ] or @[1569415393340472:274:Spilt Milk] member (with a completed membership and confidentiality form), and are attending for support with your infant/child with reflux or who spills or is irritable, you will need to complete one of these forms on the day. Please contact us for your personal invitation.

  • #NationalInfantandChildGastricRefluxAwarenessWeek Story 4

    My first child was a dream, eat sleep play.

    My second baby was a nightmare! Screaming the moment he was born. Sleeping upright on my chest for ten weeks!

    We couldn't find an answer, losing our minds! Five doctors later, high doses of medication for gastro-oesophageal reflux disease and specialised formula we had a baby we could cope with, only just.

    He spilled until one and a half, was on formula and medication until three years and is now a beautiful amazing boy at 8 years.

    It was worth every minute of personal pain and we risked it again by having son number 3 who was a dream like the first.

    Keep your head high, things will be okay, struggle through but never give up!! Your baby will grow into a beautiful human being.

    Melissa, GRSNNZ Member

  • We need 3 more short stories or articles for Awareness Week. Please use the Contact Button App or private message the National Coordinator if you are a member.
    Thank you.

  • I'm not sure if we were clear enough yesterday. :-(

    If you want to promote National Infant and Child Gastric Reflux Awareness Week or if your business or organisation has been asked to do so by someone other than the Gastric Reflux Support Network NZ, please share one of our posts unaltered without any links to any other page, group or business other than the links in the comment below.

    If you would like further information on National Infant and Child Gastric Reflux Awareness Week, please feel free to contact us using the Contact Button App on this Page. Do NOT accept information from anyone other than GRSNNZ.

    GRSNNZ has been promoting National Infant and Child Gastric Reflux Awareness Week for a long time and has been given funding to do this. It is linked solely to them with their website, and the Awareness Week Logo/Graphic is owned by GRSNNZ with the trademark baby, organisation name, slogan and colours. Permission must be given or sought before it is used other than by sharing a post unaltered as stated above.