On childrens diagnosis and treatment of gastroesophageal reflux disease.doc

 PAGE \* MERGEFORMAT 9 On children’s diagnosis and treatment of gastroesophageal reflux disease [Keywords:] diagnosis and treatment of gastroesophageal reflux disease of children GERD (gastroesophageal reflux, GER) refers to the stomach contents into the stomach from the duodenum bile salts and anti-trypsin into the esophagus. Points both physiological and pathological. Pathologic reflux with clinical symptoms, said gastroesophageal reflux disease. pathologic reflux is due to lower esophageal sphincter (LES) dysfunction, reduced ability of esophageal clearance, esophageal mucosal damage and barrier function of the stomach, duodenum, caused by dysfunction. [Diagnostic points] 1. Clinical manifestations (1) The symptoms of esophagus 1) and vomiting: is the baby of the major clinical manifestations of GER. In addition to the general galactorrhea, the considerable part of the progressive injection of vomiting. Vomit mostly milk and milk block, can also be yellow or grass green for the stomach contents, indicating with have duodenal gastroesophageal reflux. some as bloody vomit or with coffee-like objects, reflecting the complicated esophagitis caused by bleeding. 2) nausea: GER in older children the main symptoms. Regurgitation of acidic gastric juice fasting reflux, known as “acid reflux.” But it may have bile, pancreatic juice overflow. Occurrence of nausea during sleep, patients often are not aware of , woke up the pillow is survived visible signs of gastric juice or bile. 3) Heartburn: It is the most common symptoms of older children, mostly for the upper abdomen or chest of a warm feeling or a burning sensation, typically occurring in 1 to 2 hours after meals. 4) chest pain: is also found in older children, pain in the sternum, the xiphoid or the lower abdomen, often radiating to the chest, back, shoulders, neck, jaw, ear and upper limbs, more radiation to the left arm, a small number of patients with hand and upper