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Tests and diagnosis
By Mayo Clinic staffDiagnosis of infant reflux is typically based on your baby's symptoms and a physical exam. If your baby is healthy, growing as expected and seems content, then further testing usually isn't needed.
If your baby's doctor suspects a more serious problem, diagnostic tests could include:
- Ultrasound. This test is used to detect an obstruction in the opening between the stomach and small intestine (pyloric stenosis).
- Lab tests. Various blood and urine tests can help identify or rule out possible causes of recurring vomiting and poor weight gain.
- Esophageal pH monitoring. To determine if irritability, sleep disturbances or other symptoms are associated with reflux of acid, it may be helpful to measure the acidity in your baby's esophagus. The doctor will insert a thin tube through your baby's nose or mouth into the esophagus. The tube is attached to a device that monitors acidity. Your baby may need to remain in the hospital while being monitored.
- Upper GI series. If the doctor suspects a gastrointestinal obstruction, he or she may recommend a series of X-rays known as an upper gastrointestinal (GI) series. Before the X-rays, your baby is given a white, chalky liquid (barium) to drink. The barium coats the stomach, which helps any abnormalities show up more clearly on the X-rays.
- Upper endoscopy. Your baby's doctor may use this procedure to identify or rule out problems in the esophagus, such as narrowing (stricture) or inflammation (esophagitis). The doctor will insert a special tube equipped with a camera lens and light through your baby's mouth into the esophagus, stomach and first part of the small intestine. Samples of any suspicious tissue may be taken for analysis. For infants and children, endoscopy is usually done under general anesthesia.
References
- Gastroesophageal reflux in infants. National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/gerdinfant/gerdinfant/ Accessed Oct. 10, 2012.
- Winter HS. Gastroesophageal reflux in infants. www.uptodate.com/index. Accessed Oct. 10, 2012.
- AskMayoExpert. Gastroesophageal reflux in children. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2012.
- Wilkinson JM. (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 31, 2012.
- Vandenplas Y, et al. Pediatric gastroesophageal reflux clinical practice guidelines: Joint recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN). Journal of Pediatric Gastroenterology and Nutrition. 2009;49:498.
- Full-term infants: Issues to consider: Reflux. Pediatric Nutrition Care Manual. Academy of Nutrition and Dietetics. http://nutritioncaremanual.org/index.cfm. Accessed March 11, 2013.
- Schurr P, et al. Neonatal mythbusters: Evaluating the evidence for and against pharmacologic and nonpharmacologic management of gastroesophageal reflux. Neonatal Network. 2012;31:229.
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