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Diagnosing Acid Reflux in Infants

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Updated April 11, 2008

Spitting up, or gastroesophageal reflux, is common in infants. This type of gastric reflux occurs during the first few months of age in more than half of all infants. When parents burp their babies, sometimes "wet burps" occur, which means some formula is refluxed. This spitting up is normal, and gradually decreases over the first year of life. It generally requires no evaluation unless there is evidence of additional problems, such as esophagitis or failure to thrive. For a small number of babies, however, symptoms of reflux are severe or don't decrease as the infant grows older, and medical evaluation is needed.

If your baby is healthy and growing well, the doctor may make a diagnosis of reflux on a parent's description of symptoms and feeding history, and a physical exam alone. Many, if not most, cases of reflux in infants are diagnosed without the need for any testing. However, your baby's doctor may order tests if he suspects a more serious condition, such as GERD. In these cases, diagnostic tests may include:

Lab tests
This can consist of various blood and urine tests to identify or rule out possible causes of recurring vomiting and poor weight gain.

Upper endoscopy
The upper endoscopy (also known as esophagogastroduodenoscopy or EGD) allows the doctor to examine the inside of the patient's esophagus, stomach, and duodenum with an instrument called an endoscope, a thin, flexible, lighted tube.

Esophageal pH monitoring
This test will measure the acidity in your baby's esophagus. The pH procedure is done with a thin, plastic tube with a sensor that measures the amount of acid backing up into the esophagus. This procedure is often done when GERD symptoms are present but an endoscope exam doesn't detect any evidence of reflux disease. The pH test measures how often and for how long stomach acid enters the esophagus, and how well it clears the esophagus.

Additional Information:

Sources:

Marsha Kay, M.D. and Vasundhara Tolia, M.D., "COMMON GASTROINTESTINAL PROBLEMS IN PEDIATRIC PATIENTS." The American College of Gastroenterology. 9 Apr 2008.

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