Regurgitation syndrome is one of the most common reasons for parents of young children to consult a pediatrician and a surgeon. The causes of regurgitation in children under 1 year of age vary: anatomical and functional features, neurological disorders, infectious processes, malformations or other problems. The mechanism that prevents regurgitation and vomiting in children is very complex and depends on the anatomical structure and physiological processes of the child. The formation of this mechanism occurs in the last trimester of pregnancy and continues in the first months of the child's life. Although regurgitation and vomiting can be a symptom of various diseases, these processes themselves are physiological, i.e. normal. The pathological discharge of stomach contents into the esophagus is called gastro-esophageal reflux, and the mechanism that prevents vomiting is called the antireflux mechanism.
Anti-reflux mechanism in children
In children, the nervous regulation of the antireflux mechanism is very complex and is easily disrupted by external and internal factors. Regurgitation and vomiting easily occur in children with an immature antireflux mechanism if the feeding regime or volume is incorrectly selected, as a reaction to artificial mixtures, at the slightest signs of infectious processes. This is especially common in children with intrauterine growth retardation and premature infants, as well as in severe pregnancy and toxicosis, caesarean section, complicated childbirth, etc.
When to see a doctor
Despite the fact that moderate regurgitation in a child under 6 months of age is considered a variant of the norm, parents should definitely tell the pediatrician about this during a routine checkup. The reason for serious concern and immediate examination of the child is an increase in the frequency or increase in the volume of regurgitation, the appearance of streaks of blood or bile impurities, a lag in weight gain or weight loss, high fever. In this case, it is necessary to urgently consult a surgeon to rule out surgical causes.
Diagnostics
In most cases, an ultrasound examination (ultrasound) is necessary to establish an accurate diagnosis and select the right treatment. An experienced ultrasound diagnostic doctor helps to establish the correct diagnosis in more than half of the cases. Sometimes, for a more accurate diagnosis, flexible gastroscopy, X-ray examination or computed tomography of the abdominal organs are performed.
When surgical intervention is required
Pyloric stenosis, or a violation of the patency of the outlet of the stomach, is the cause of the most severe regurgitation syndrome (vomiting "fountain") in children under 2 months of age, it is accompanied by a marked loss of body weight and an increasing deterioration in the child's condition. This disease requires urgent surgical care. In leading clinics, such operations are performed using a minimally invasive laparoscopic method. The current level of development of surgery and pediatric anesthesiology allows the use of endoscopic surgery techniques even in children of the first weeks of life.
There are also other causes of regurgitation that require surgical intervention, such as hernias of the esophageal orifice of the diaphragm, chalasia (gaping) of the esophagus, and others. These malformations are characterized by a violation of the formation of the antireflux mechanism and lead to constant regurgitation in the child, impaired weight gain, decreased appetite, chronic cough, bronchial asthma, anemia. If drug therapy is ineffective, then a gastrofundoplication operation is indicated, in which an artificial antireflux valve is surgically formed. Like many other interventions, in modern pediatric clinics, this operation is performed laparoscopically – with less trauma, minimal blood loss, minimal cosmetic defect and rapid recovery of the child after surgery.
Of course, vomiting and regurgitation can be symptoms of many other diseases and occur at any age of a child. So, vomiting is often noted in acute appendicitis and intestinal obstruction, it can be a symptom of intestinal infection, intoxication, etc. In addition to the disease itself, vomiting and excessive regurgitation are dangerous because the child loses a lot of water and essential salts for life, which can lead to dehydration – exsicosis. The younger the child, the faster the breakdown of compensatory mechanisms occurs and the aggravation of his condition. Therefore, the appearance of symptoms of vomiting or pronounced regurgitation in young children requires immediate medical attention to identify the causes, establish a correct diagnosis and choose the optimal treatment, and, if necessary, surgical treatment.
The EMC Children's Clinic is staffed around the clock by experienced pediatricians and surgeons who provide emergency and routine care to children of all ages, starting from the first days of life.
If surgical treatment is necessary, minimally invasive endoscopic surgical procedures are the method of choice in our clinic, which in most cases allow the child to be released home on the day of the operation. The operation is accompanied by an experienced anesthesiologist, who individually selects modern and safe anesthesia for each child. The postoperative wards are equipped with high-tech equipment, where round-the-clock monitoring systems are installed, and a separate nurse continuously monitors the condition of young patients.
In the comfortable hospital of the EMC Children's Clinic, parents can stay with their child all the time, round-the-clock visits are open for relatives and friends, which allows for maximum comfort for the child and parents.
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