From the page
about reflux, you've already learned what reflux is. Here, we will go
into more detail on the different terms used to refer to reflux. This
information applies to adults as well, not just infants with 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. |
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what is
GER?
When a baby or child (or anyone for that matter) is referred to as
having GER, the term represents a benign condition in which the child is
having frequent "reflux" episodes. This is also called "Functional GER"
and does not cause complications, lead to long term problems, affect
growth or development or even necessarily require
medical intervention. The category of GER can range from reflux
material simply entering the distal (bottom of the) esophagus to spitting
up and even frequent projectile vomiting. Projectile vomiting alone is
not considered to be a complication and as long as no other complications
arise, it is considered GER.
when is ger really called 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.
what about secondary ger?
In secondary GER, there is some underlying cause of the reflux
episodes, something else is going on to cause the reflux episodes. Some
examples of secondary GER would be
pyloric stenosis, food is being refluxed out of the stomach but it is
actually being caused by the pyloric sphincter being blocked. Other
examples of secondary GER would be food allergies, metabolic disorders,
infection, NG tubes, etc.
what is silent ger?
Silent GER refers to GER or GERD without any outward or typical
symptoms. This could mean that a child isn't vomiting or appearing
uncomfortable but is having reflux episodes. Some children may swallow
the refluxed material (refluxate) back down instead of throwing it up, in
some kids it may not come up enough to actually come out the mouth. This
can be much more difficult to diagnose, since the most common symptoms are
not present. It can also be more damaging as the refluxate burns the
esophagus on the way up and again on the way down. Whether or not the
silent reflux needs to be treated depends on the complications that are
arising from it.
Laryngopharyngeal Reflux
When reflux makes it's way up all the way up through the upper
sphincter and to the back of the throat causing problems with hoarseness,
sore throats, chronic cough, etc, it's referred to as
Laryngopharyngeal Reflux.
*Physiologic - normal, not pathologic, characteristic
of or conforming to the normal functioning or state of the body or a
tissue or organ.
**Pathologic - Indicative of a specific condition, not
physiological.
Reviewed By Dave Olson, MD
Fellow, American Academy of Pediatrics
Graduate University of Michigan School of Medicine |
