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Clinical features

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Features are as follows:

  • regurgitation or persistent vomiting - generally posseting
    • the vomiting usually occurs after a feed when a small amount of food is regurgitated. From then until the next feed regurgitation may continue.
    • at times the vomiting may forceful and may even be projectile.
    • the vomit is never bile-stained but may contain frank or altered blood or mucus. Bile stained vomit implies a surgical cause - particularly volvulus - until proven otherwise.
  • feeding refusal
  • back arching/irritability/persistent crying (1)
  • poor weight gain and failure to thrive - most infants with this condition thrive normally and are not distressed by this condition, although in some infants the vomiting may be severe enough to restrict growth (2)
  • oesophageal symptoms - haematemesis, dysphagia, odynophagia - may occur in severe disease
  • anaemia - may occur in severe disease
  • respiratory symptoms may be present in severe disease - wheezing, stridor, cough, hoarseness, apnoea spells with cyanotic episodes (apparent life-threatening events) (2,3)
  • there may be aspiration of milk so that the presentation will be that of cough and wheezing
  • dental erosion (3)
  • abnormal hyperextension of the neck with torticollis - Sandifer's syndrome
  • sleeping difficulties (1)

All infant with GORD will not present with visible regurgitation (“silent” GORD) (2)

Reference:

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