Paediatrics: Childhood GORD: Free MSRA Podcast

👶 FREE MSRA PODCAST – Gastro-oesophageal Reflux in Children: Spot the Difference, Treat the TroubleIn this episode, we break down Gastro-oesophageal Reflux (GOR) and GORD in children, transforming a complex, common paediatric topic into high-yield, exam-ready knowledge. Get the confidence to tell the difference between harmless baby spit-up and reflux disease that actually needs action.🧠 Key Learning Points📌 Definition• GOR: Non-forceful regurgitation of stomach contents (spit-up); common and physiological in infants• GORD: Gastro-oesophageal reflux disease — reflux causing persistent symptoms or complications (pain, poor growth, distress)📌 Causes & Risk Factors• Main cause: Immaturity of the lower oesophageal sphincter (LES) in infants• Other contributors: Delayed gastric emptying, poor oesophageal motility, increased intra-abdominal pressure• Risk factors: Prematurity, neurological disorders (e.g., cerebral palsy), repaired congenital anomalies (e.g., hiatus hernia, oesophageal atresia), obesity, family history of reflux📌 Pathophysiology• LES fails to close or relaxes inappropriately• Stomach contents, including acid, flow back into oesophagus, causing irritation and sometimes injury📌 Clinical Features• Infants: Effortless vomiting or regurgitation, irritability during/after feeds, arching back, poor weight gain, excessive crying• Older children/adolescents: Heartburn, epigastric/retrosternal pain, regurgitation, chronic cough, respiratory symptoms (wheeze, apnoea), faltering growth• Red flags: Forceful/bilious vomiting, haematemesis, blood in stool, severe distress, persistent symptoms after 1 year, fever, poor responsiveness📌 Differential Diagnosis• Eosinophilic oesophagitis, GI obstruction, food allergy, chronic infections, primary motility disorders📌 Diagnosis• Primarily clinical: Based on history and symptoms• Investigations: Reserved for atypical, severe, or complicated cases – 24hr pH study (quantifies acid exposure) – Barium swallow (anatomy) – Endoscopy + biopsy (oesophagitis, other pathology) – Manometry (motility)• Always investigate for UTI in infants with regurgitation + faltering growth📌 Management• Stepwise approach: 1. Lifestyle: Upright feeding, smaller/more frequent feeds, thickened feeds (do not use sleep wedges—safe sleep = on the back) 2. Medication: For troublesome GORD only — PPIs (omeprazole), H2RAs (if available), prokinetics (rare/last resort) 3. Enteral feeding: For faltering growth unresponsive to above 4. Surgery: Fundoplication for severe, refractory cases• Specialist referral for complex, persistent, or red flag cases📌 Prognosis & Complications• Prognosis: Excellent — 90% resolve by 1 year, 55% by 10 months, nearly all by 18 months• Complications if persistent/severe: Oesophagitis, aspiration pneumonia, recurrent otitis media, dental erosion, failure to thrive📎 More MSRA Resources for Paediatric GORD:📝 Revision Notes: https://www.passthemsra.com/topic/gastro-oesophageal-reflux-in-children-revision-notes/🧠 Flashcards: https://www.passthemsra.com/topic/gastro-oesophageal-reflux-in-children-flashcards/💬 Accordion Q&A: https://www.passthemsra.com/topic/gastro-oesophageal-reflux-in-children-accordion-qa-notes/🚀 Rapid Quiz: https://www.passthemsra.com/topic/gastro-oesophageal-reflux-in-children-rapid-quiz/🎓 Paediatrics Course: https://www.passthemsra.com/courses/paediatrics-for-the-msra/#MSRA #GORD #Paediatrics #MSRARevision #MSRAQuiz #MSRAFlashcards #MSRAAccordions #ChildHealth #PaediatricReflux #MSRATextbook