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Gastro-esophageal reflux: the point

Gastro-esophageal reflux: the point


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Medical consultations for regurgitation increase: should we really worry about it? How to distinguish "normal" regurgitations from a real GERD? The point with Professor Patrick Tounian.

Does GERD (Gastroesophageal Reflux Disease) affect more infants than before?

  • No, infants have always been subject to regurgitation. The pathology is not more widespread, but it seems that parents tolerate it less. When they are frequent and abundant, they constitute an embarrassment for the child ... but especially for them. This discomfort depends greatly on the family: one will tolerate eighteen regurgitations a day without blinking while the other will consult after three.

How to distinguish "normal" regurgitations from a real GERD?

  • This is a real GERD when regurgitations are accompanied by other pathologies. These complications can be bronchitis - even asthma - and repeated laryngitis.
  • The mechanism is as follows: the acidity goes up to the oropharyngeal junction (the laryngeal opening goes to the lungs, the pharynx goes to the stomach). At this level, the acidity can "go wrong" and fall back into the wrong hole, causing inflammation. Another possible complication, but much rarer, is oesophagitis. This inflammation of the esophagus can be spotted by bloody regurgitation and will be confirmed by fibroscopy. Many parents think - very often wrongly - that a child who cries a lot and regurgitates suffers from oesophagitis. In fact, this pathology affects less than 1% of infants.

When is consultation required?

  • Apart from the complications described above, it is necessary to consult when the threshold of tolerance of the parents is exceeded. Regurgitations are primarily a problem of comfort and generally have no serious character for the health of the child. The regurgitations are physiological in the infant of a few months, since its antireflux system is not yet functional. To a certain extent, they are therefore "normal". Very few babies do not regurgitate at all.
  • If the parents can no longer support these regurgitations, especially if they are bulky that is to say close to vomiting, you must consult. As much to treat them as to look for another diagnosis, such as an allergy to cow's milk proteins or an anatomical malformation.

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