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Diagnosis and treatment of gastro-oesophageal reflux disease (GORD) in patients less than 6 months old on a tertiary cardiology/cardiothoracic surgery ward
  1. TDR Sproat,
  2. TE Richens
  1. Cardiology Department, Royal Hospital for Sick Children, Glasgow, UK

Abstract

Aims To identify:

  • what patients in this age group were diagnosed with GORD;

  • what symptoms these patients had at diagnosis and whether other diagnoses were considered;

  • how GORD is treated in patients under 6 months.

Abstract G91(P) Table 1
Abstract G91(P) Table 2

Method A bespoke congenital cardiac database was used to identify all the cardiology and cardiothoracic surgery patients admitted between 01/01/11 and 01/10/11 and treated for GORD.

After consultation with a Consultant Gastroenterologist an audit proforma was used to collect the demographics, cardiac diagnosis, symptoms at start of treatment and treatment they received for GORD.

Results 29 out of 61 (48%) patients, under 6 months of age, admitted were treated for GORD. 2 patients remain inpatients in ITU and are therefore not included in this audit.

  • 15/36 (41%) of male admissions and 12/25 (48%) of female admissions were treated for GORD

  • Mean age at diagnosis was 2 months.

  • Mean weight at diagnosis was 3.77 kg (midway between the 9th and 25th centile).

  • Commonest presenting symptoms were vomiting (14 patients) then symptoms of aspiration (11 patients) and poor weight gain (9 patients).

  • In 13 cases other causes of symptoms were considered (eg, Heart failure, constipation).

  • Only 2 patients underwent GI investigations. One had a barium meal and then started on a pro-kinetic agent. The second underwent a barium meal and then fundoplication.

Conclusion GORD is commonly diagnosed in cardiac patients in this age group.

Effected patients generally sit on lower centiles for weight.

Whilst the treatment options for GORD are recognised the treatment order is not consistent.

There are no national guidelines for treatment of GORD in children.

A guideline for GORD treatment may improve patient care and could be based on international (NASPGHAN/ESPGHAN) guidance.

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