ABSTRACT
Gastroesophageal reflux (GER) is a common disorder in infants and children with a high rate of spontaneous resolution. Some children, however, will continue to have problems and progress from functional GER to pathogenic GER. In children with functional GER, diagnostic testing and pharmacologic treatment is unnecessary. In more involved cases, there are a number of tests available that help to quantify and qualify the extent of disease. Treatment begins with conservative measures and progresses to acid neutralization/supression and medications to enhance motility. Should medical management fail to control the consequences of reflux disease, surgical intervention is warranted.
Subject(s)
Gastroesophageal Reflux/therapy , Child , Eating , Gastroesophageal Reflux/classification , Gastroesophageal Reflux/etiology , Gastroesophageal Reflux/physiopathology , Humans , Infant , PostureABSTRACT
A 16-year-old Caucasian male presented with nausea, vomiting, and abdominal pain. Endoscopy revealed erythematous antral mucosa with four discrete gastric ulcers. Biopsies showed multiple spiral organisms, 4-6 microns in length, lying in the mucous layer on the surface. The organisms were strongly Giemsa positive and weakly CLOtest positive. They did not stain with Warthin-Starry silver or Gram-Weigert stains. Electron microscopy revealed fragments of Gastrospirillum hominis, with its characteristic spiral shape and length of 4 microns in the plane of section. We believe that this is one of the first reported pediatric cases in North America.
Subject(s)
Bacterial Infections/pathology , Gastritis/pathology , Helicobacter heilmannii , Adolescent , Chronic Disease , Gastritis/microbiology , Helicobacter heilmannii/ultrastructure , Humans , Male , Pyloric Antrum/microbiology , Pyloric Antrum/pathologyABSTRACT
Aluminum toxicity is a documented cause of encephalopathy, anemia, and osteomalacia. Excretion is primarily renal; therefore, patients with renal insufficiency are at risk for aluminum accumulation and toxicity. This has been demonstrated in uremic children treated with aluminum-containing antacids. The purpose of this study was to determine whether plasma aluminum levels were elevated in infants with normal renal function during prolonged aluminum-containing antacid use. Ten study infants (mean age = 5.8 months), who had been receiving antacids for at least 1 week, were compared with 16 control infants (mean age = 9.8 months) not receiving antacids. The study patients consumed 123 +/- 16 mg/kg per day (mean +/- SEM) of elemental aluminum for an average of 4.7 weeks. Their plasma aluminum level (37.2 +/- 7.13 micrograms/L) was significantly greater than that of the control group (4.13 +/- 0.66 micrograms/L) (P less than .005). It is concluded that plasma aluminum levels may become elevated in infants with normal renal function who are consuming high doses of aluminum-containing antacids. The safety of antacids containing aluminum should not be assumed and they should be used judiciously in infants, with careful monitoring of the aluminum dose and plasma level.
