A wet burp or wet hiccup is when an infant spits up liquid when they burp or hiccup. This can be a symptom of acid reflux or, less commonly, GERD. Acid reflux happens when the contents of the stomach back up into the esophagus. Upper endoscopy. A special tube equipped with a camera lens and light (endoscope) is passed through your baby’s mouth and into the esophagus, stomach and first part of the small intestine.
Carbonated or caffeinated beverages may be associated with GERD. In some cases, medications may be indicated. Signs and symptoms of GER or GERD in infants and children are overlap.
It is important to note that classic “heartburn” symptoms may resolve, but more subtle evidence of reflux (for example, persisting cough, especially when laying face up [supine]) may develop. Your child’s pediatrician is a valuable asset to help monitor for these less obvious presentations of GERD. The diagnosis of GER is based upon characteristic historical facts reported by the infant’s parents coupled with an elimination of pathological conditions by a normal physical exam. It is very rare to need laboratory studies to establish or support the diagnosis.
Infants and children with GER have obvious reflux of breastmilk and/or formula following feeding. Usually, such infants do not appear to be in distress by such episodes. Silent reflux is common in infants because their sphincters are undeveloped, they have a shorter esophagus, and they lie down much of the time.
If youâ€™re bottle feeding, hold the bottle at an angle that allows the nipple to stay full of milk. This will help your baby to gulp less air. Swallowing air can increase intestinal pressure and lead to reflux. Babies are prone to reflux – be it GERD or LPR – because of a number of factors.
Gastroesophageal reflux (GER) is defined as the involuntary retrograde passage of gastric contents into the esophagus with or without regurgitation or vomiting. It is a frequently experienced physiologic condition occurring several times a day, mostly postprandial and causes no symptoms. These infants are also called ‘happy spitters’. GER disease (GERD) occurs when reflux of the gastric contents causes symptoms that affect the quality of life or pathologic complications, such as failure to thrive, feeding or sleeping problems, chronic respiratory disorders, esophagitis, hematemesis, apnea, and apparent life-threatening events.
This is confirmed by scintigraphic demonstration of aspiration of radio-labeled isotope into the airway in some patients with GERD and respiratory symptoms. Another theory suggests that distal esophageal acidification results in vagal stimulation and consequent broncho-constriction, independent of airway micro-aspiration. This theory gains support from the observation that not all patients who develop bronchospasm have demonstrable proximal esophageal acidification. Further, even among those who show abnormal proximal esophageal pH, there is improvement in respiratory symptoms with control of distal gastroesophageal reflux alone. It is also possible that physiological changes in asthma, including increased lower esophageal pressure, the mechanical influence of a depressed diaphragm caused by hyperinflation, and cough mediated by increased abdominal pressure, may contribute to gastroesophageal reflux to some degree. In addition, some of the medications used for treatment can aggravate gastroesophageal reflux; thus, there is a perception that gastroesophageal reflux may be an effect rather than cause of chronic respiratory conditions. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Acid Reflux in (GER and GERD) in Children and Teens, April 2015.
Some infants or children with GERD may even become averse to feeding due to repeated associations with feeding and pain. Finally, there are a number of short and long term consequences of GERD that are not associated with infants and children with GER. Gastroesophogeal reflux is different from vomiting because usually it is not associated with a violent ejection. Moreover, GER is generally a singular event in time, whereas the vomiting process is commonly several back-to-back events that may ultimately completely empty all stomach contents and yet still persist (“dry heaves”).