Diagnosing Infant Reflux Disease

Pediatricians, along with a pediatric Gastroentronologist, will make an initial diagnosis of infant reflux based on a parents description of their child’s symptoms, the child’s feeding history, and through a physical exam.  If the diagnosis seems to be more involved and serious as in GERD, further procedures may be done to rule out any other medical conditions and to confirm the reflux. 
 At the present time, doctors have taken a different approach.  They are treating the infants symptoms with a trial of certain medications first before doing any invasive procedures.   

Procedures Used to Diagnose GERD:
pH Probe – 
A thin tube, with a probe at the tip, is placed through the nose into the esophagus. The tip is positioned at the lower part of the esophagus, allowing it to measure the pH levels of stomach acids that is regurgitated. The frequency of reflux is monitored over a prolonged period of time, usually 24 hours.  Depending on the doctor an infant with be sent home with the monitor/probe in place or be observed in a hospital.  Also an infant can be given it’s normal formula/breastmilk or may be given apple juice for the test.  
Currently this test is considered to be the best test to diagnose reflux

*If you have a choice I would do this test in a hospital setting. Especially if they are using strictly apple juice.  Two of my sons had this procedure done.  My second son was already on meds. His reflux was under control but he was still have some issues.  This test confirmed his reflux was under control but also made us realize he had a milk protein allergy.  He had no issues with this test.  However my third son’s reflux wasn’t under control and he had a horrible experience with increased vomitting/choking. (apple juice was used for the entire 24 hr period)

Upper GI (barium swallow): 
A special X-ray test that uses barium to highlight the esophagus, stomach and upper part of the small intestine. This test can identify GERD (but doesn’t always manage to detect the disease as babies reflux at different times) and other potential problems such as any obstructions or narrowing in these areas that could be causing the infants symptoms.
A baby is given a white, chalky liquid (barium) to drink through a bottle. As the baby swallows the barium a series of x-rays are taken. The barium coats the stomach, which helps any abnormalities show up more clearly on the X-rays.

Upper GI endoscopy:
 A endoscope (a thin, flexible lighted tube with a camera) is used to look directly inside the esophagus, stomach and upper part of the small intestine. Pinch biopsies of the esophagus obtained at the time of endoscopy may determine the presence of reflux. (this is usually done as a last resort after all other options have been exhausted.  For infants, endoscopy is usually done under general anesthesia.

Gastric Emptying Study:
During this test, the child drinks milk or eats food mixed with a safe radioactive chemical. This chemical is followed through the gastrointestinal tract using a special camera.
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