distinguish from regurgitation (passive ejection of gastric contents secondary to reflux) Infectious GI causes: gast...
- distinguish from regurgitation (passive ejection of gastric contents
secondary to reflux)
GI causes:
- gastroenteritis
- peritonitis
- appendicitis
- hepatitis
- ulcers
- pancreatitis
Non-GI causes:
- UTI
- otitis media
- CNS infection
- raised ICP
- almost any infection
- drugs
- foreign body
Anatomic
GI tract obstruction
- intussusception (see below)
- foreign body e.g. bezoar
Gastroesophageal reflux
- usually temporary relaxation of lower esophageal sphincter
----> decreased gastric emptying - presents with recurrent vomiting after feeds and FTT
- most outgrow reflux by 18 months of age
- conservative management: thickened feeds, elevate bed to 30 degrees
- esophagograms may miss, pH studies are preferred
- treat only if symptomatic or poor weight gain medication e.g. cisapride, H2 blockers
- if unresponsive to medication: surgery - Nissen fundoplication
- complications: aspiration, esophageal bleeding, stricture formation, apnea
- increased ICP
- hydrocephalus
- neoplasm
- drugs/intoxicants
- migraine
- meningitis, encephalitis
Other
- metabolic/endocrine e.g. DKA, inborn errors, liver failure
- poisons/drugs: e.g. lead, digoxin, erythromycin, theophylline
- psychogenic: e.g. rumination syndrome, bulimia, anorexia, cyclic vomiting
- food allergy
- regurgitation
- overfeeding
