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Vomiting,acid reflux,colic,h pylori

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General & Family Physician
Practicing since : 2010
Answered : 126 Questions
My son is 5 months old and has also had trouble with spitting up. Since birth we have fought this battle. He has been on 6 or more different formulas along with 3 different types of meds for reflux... However along with the spitting up he can and is very fussy. Not while he eats but afterwards alot of time. He will have spells where he just cries and screams. As if he is in major pain. Several different docs have told me it's colic, and reflux but none of the meds or different formula have helped at all... I still feel somthing else is truly wrong. He did go for an upper gi yesterday and it came back normal. What should the next step be? I have done alot of research and found somthing called h pylori which sounds somewhat liker my son, vomiting or spitting up several oz. of milk, gains weight VERY slowy. He is 5 months and weight 13 months he weight 6.9 at birth. He burps often and I even think he bloats up alot after feedings.. What do you think??? Please help.. I just want him to be a happy healthy baby..
Posted Tue, 8 May 2012 in Child Health
Answered by Dr. Tulasi Raman.P 2 hours later

Thanks for writing to us.

I can understand your anxiousness about your son.

To clarify your doubts I will answer in points which will make it simpler for you to understand.

Reflux is a normal phenomena seen in newborn babies upto the the age of 3-5 months in many and upto 2 years in a few due to the immature lower esophageal sphincter.

It is a natural mechanism to let out the air that the baby swallows with and without meals.

This prevents bloating of the stomach. In few babies if the reflux is absent it causes many more symptoms due to GI upset.

Reflux in few normal babies can scare the caretaker, parents and the physician.

But if the frequency of the reflux is more, then it needs to be evaluated as it can be due to many causes. To name a few:

Gastro-esophageal reflux syndrome.

oesophageal web.

Overweight babies.

Iron deficiency anaemia.

Increased acid and pepsin secretion.

Ulcer and strictures.

Pyloric stenosis.

Pyloric strictures.

These are few disease conditions which can cause excessive regurgitation/vomiting and most of these can be diagnosed by upper GI endoscopy and Ultrasonograghy.

If the condition is excessive then it can be associated with aspiration of food particles into the lungs and cause pneumonia, failure to gain weight, always hungry, loss of weight, failure to thrive.

Pyloric stenosis causes similar symptoms, it is caused due to hypertrophy(excessive growth than normal) of the pyloric part of the stomach which slow down/prevents passage of the food to the intestine.
It can be felt as a mass by the hand on the stomach. The movement of stomach to push the food through it also will be visible to the eyes sometimes after food. It requires operative treatment.

Treatment as such consists in minimizing the frequency of meals and its side effect. Normally giving a thick but semisolid paste of formulas will reduce the frequency.

Posturing the child upright for few minutes after every feed especially on mothers chest upright helps in burping which lets out the air and reduce the frequency.

See to it that during breast feeding the baby seals its mouth on the nipple properly. And place the child in a slanting and not in horizontal position while breast feeding.

These measures along with the medication you mentioned should work out. Remember reflux as such will persist until the Lower esophageal sphincter matures.

If still there is no improvement then further investigation for specific congenital and acquired syndromes should be done and appropriate Treatment started.

I hope this answers your doubt.

If you have more queries feel free to write. I will be available to answer.

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