GER Jeopardy!

Pathophysiology & Prognosis

100

This muscle’s immaturity in infants is the main reason why reflux occurs during early development

Lower esophageal sphincter (LES)

300

What percentage of infants with GER improve by 9–12 months of age

95%

500

What complications can occur after surgical treatment for GER?

Infection

Dysphagia

Gas-bloat/Dumping Syndrome

Recurrence

Treatment

100

This class of drugs, which includes omeprazole, is the pharmacological treatment of choice for pediatric GER

PPIs (Proton Pump Inhibitors)

300

Antacids can be used for children, but they are not recommended for this patient population

Infants

400

What developmental milestone helps to reduce reflux symptoms at approximately the age of 12 months

Standing upright

500

These surgeries may be recommended for severe GER(D) (Name 1/3)

Laparoscopic Anti-Reflux Surgery (LARS)

Nissen Fundoplication

Esophagogastric Disconnection aka. Bianchi procedure

Diagnosis

200

A baby with frequent coughing and poor weight gain is suspected of reflux. The nurse wants to confirm acid exposure in the esophagus over time. What test should be ordered

Esophageal pH test

300

When does gastroesophageal reflux become gastroesophageal reflux disease (GERD)

When it causes poor growth, respiratory problems, or significant feeding difficulties

400

This test involves a child drinking a special liquid so X-rays can show how food moves through the upper digestive tract

Barium swallow

500

Endoscopic evidence of esophageal inflammation from prolonged, untreated acid exposure in a child indicates this diagnosis

Progression to GERD

Teachings

100

How should infants with GER be positioned to reduce reflux

Upright or left lateral (supine positioning increases reflux)

200

This type of feeding schedule helps keep the stomach from getting too full, causing regurgitation

^{Small, frequent feedings?}

300

Suggest avoiding this type of food in older children with GER (Name at least 2)

Spicy foods

Fatty foods

Peppermint

Chocolate 

Fried foods

400

When should GER medication be given for best effect

Before meals

500

What feeding modification can help reduce regurgitation in bottle-fed infants with GER

Thickening formula with rice cereal or a commercial thickening agent