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Infants may present with recurrent vomiting, multiple chest infections and sometimes fail to thrive or grow as a result of GERDS and LPR. The diagnosis in these infants depends on testing for acid in the esophagus with special acid sensitive probes by what is called pH-metry. Most major hospitals have set up such units that have been very successful in diagnosing these patients in very early infancy to the point that before the advent of laparoscopic anti-reflux procedures, the pediatric surgeons were much busier doing these operations than adult population surgeons. THE MOST UNFORTUNATE GROUP OF PATIENTS ARE THOSE WHO PASS INFANCY UNDIAGNOSED! Many of these patients have a strong family history of reflux but their pediatricians and even pediatric gastroenterologists seem to be oblivious to the plight of these children. I have personally referred children of patients who gave a history of a lifetime of suffering with reflux and heartburn, who went on to develop Barrett esophagus, with all the increased risk of developing cancer as pointed out above, before getting laparoscopic surgery. These patients are then treated medically instead of being diagnosed then referred to pediatric or laparoscopic surgeons. |
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