Baby reflux

Definition

Reflux is composed of the terms re (lat. back/back) and flux (from lat. fluere=flow) and describes a reflux of parts of the stomach contents into the esophagus.

Esophagus and stomach are separated from each other by a sphincter. This sphincter is permeable to food and beverages, which are transported from the mouth through the esophagus to the stomach. For the other direction, the muscle is closed and thus prevents stomach contents or gastric acid from returning to the esophagus. Almost all babies have occasional reflux. However, it is only called a disease when the child suffers from the consequences.

Causes

Especially in newborns and especially in premature infants reflux is a relatively normal occurrence. During the obligatory burping after a meal, air is mainly expelled, but some stomach contents may also be present. Between the esophagus and the stomach there is a sphincter muscle that is supposed to prevent the stomach contents from flowing back into the esophagus.

This muscle cannot always be fully controlled, especially in the first weeks and months. Sometimes it relaxes briefly after a meal or does not close completely. This allows stomach contents to flow back.

In addition, the angle at which the esophagus enters the stomach is very small in very young babies. This also promotes reflux. This usually grows out within the first months.

The drinking behavior of the babies can also influence the reflux: if the child drinks very quickly and hastily, too large quantities are often swallowed, which then make their way back up. Pathological causes can be faulty wiring or damage to the nerves. Causes in the area of the lungs are also conceivable, as they change the pressure conditions in the baby’s chest and thus possibly promote reflux.

Diagnosis

The suspected diagnosis of reflux in babies is first made based on the symptoms. The first examination that follows such a suspected diagnosis is the ultrasound. Any anatomical anomalies can be detected.

A 24-hour PH-metry is also often used, in which the acidity in the area of the esophagus is measured over 24 hours. If reflux occurs, acidic food pulp flows into the esophagus. This process can be measured with the examination. Using a 24-hour impedance measurement, the speed and pressure of the reflux can also be measured.