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Is It Colic, Infant Reflux or GERD? Learn How to Tell The Difference

   
RMacLean
June 2006

  
 

It can sometimes be difficult for a parent to understand whether the baby has colic or reflux (and even GERD) since some of the symptoms (eg. poor sleep, constant crying) can be similar. It's also extremely important to rule out reflux as a cause of this crying, as it's becoming widely acknowledged that many cases of colic are actually undiagnosed and untreated cases of reflux. In these cases, simply treating the reflux may eliminate the colicky behavior.

The easiest way to determine whether a baby has colic or reflux is to look at the definitions and symptoms of each. Then compare them to your child's symptoms.

COLIC

Colic can be defined as uncontrollable, extended crying in babies who are otherwise healthy and well-fed. All babies cry, but when they cry for more than three hours a day, three to four days a week, they are said to have colic.

Symptoms of Colic

The main symptom is continuous crying for long periods of time. This crying can occur at any time of day but it usually gets worse at night. It's not believed that colic is caused by pain although a colicky baby may look uncomfortable or appear to be in pain. They may lift their head, draw their legs up to their abdomen, pass gas and become red-faced. Poor sleep habits are also common.

REFLUX

The term reflux is a shorter way of referring to GER (Gastro Esophageal Reflux) and is simply defined as the backward flow of stomach contents up the esophagus. GER is a physiological process that happens to everyone—young and old—from time to time, particularly after meals and many times we are not even aware it is happening. In babies it generally occurs from immaturity of the LES (Lower Esophageal Sphincter) which is the muscle between the stomach and esophagus.

Some common symptoms of uncomplicated reflux can include:

  • constant or sudden crying or colic like symptoms
  • irritability and pain
  • poor sleep habits typically with frequent waking
  • arching their necks and back during or after eating spitting- up or vomiting
  • wet burp or frequent hiccups
  • frequent ear infections or sinus congestion

Your child does not need to exhibit all of these symptoms, in fact, only having one of the above could mean they have reflux. It does not; however, mean they need treatment. If your child is showing one or more of the above symptoms but is otherwise happy and healthy then some simple lifestyle modifications will likely make life better until they outgrow it.

GERD

In contrast, GER (Gastro Esophageal Reflux) is referred to as GERD (Gastro Esophageal Reflux Disease) when complications arise. GERD is a pathological process and the complications can be typical (failure to thrive, feeding and oral aversions, esophagitis, etc) or atypical (wheezing, pneumonia, chronic sinusitis, etc). Patients with GERD have complications arising from their GER that necessitate medical intervention. GERD is also referred to as "Pathogenic GER". It is estimated that approximately one in three hundred children will present symptoms of GERD and is more common in children with neurological impairments.

Symptoms indicative of Reflux Disease or GERD:

  • refusing food or accepting only a few bites despite being hungry or the exact opposite requiring constant
  • small meals or liquid
  • food/oral aversions
  • anemia
  • excessive drooling
  • running nose, sinus infections
  • swallowing problems, gagging, choking
  • chronic hoarse voice
  • frequent red, sore throat without infection present
  • apnea
  • chronic ear infections
  • respiratory problems—pneumonia, bronchitis, wheezing, asthma, night-time cough, aspiration
  • gagging themselves with their fingers or fist (sign of esophagitis)
  • poor weight gain, weight loss, failure to thrive
  • erosion of dental enamel
  • neck arching (Sandifer's Syndrome)
  • bad breath

Basically, if your baby is spitting or throwing up, or his/her fussiest,  most irritable times are during or after a feeding, it's reflux not just colic.  But remember to watch the other symptoms carefully because not all babies with reflux will spit up, this is referred to as silent reflux. Further, if your baby is experiencing any health problems that require medical intervention, it's not just colic or reflux, it's likely GERD.

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Site Last Modified: March 29, 2007
*Disclaimer: The information available on this website should not be used as a substitute for professional medical care for the prevention, diagnosis, or treatment of your child's reflux. Please consult with your child's doctor or pharmacist before trying any medication (prescription or OTC) or following any treatment plan mentioned. This information is provided only to help you be as informed as possible about your child's condition.
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