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Maternal (Expert Forum)
GERD and fundoplication
Patient medical question and answer from The Maternal and Child Health Forum. Health topic area and articles about newborn care
GERD and fundoplication
by Lora-Smith, Jan 13, 1999 12:00AM
Hi, I have a 4mth old aughter who was born at 32weeks wth GERD. She has been on cisapride and zantac for 2 mths and still having problems. The Dr has scheduled aph probe for Monday , and she says she thinks she is severe enough that a fundo is going to be needed. We will see. My questions are, if she says she does(She thinks they will find a very irritated esophagus that could lead to scarring f left untreated)want to do surgury wouldnt it be prudent to at least wait a few months to see if she outgrows this? I have read about the conplications that the adults have had with their fundos on the gastro board and I am not sure that my daughters quality if life would even be improved? How do mst babies do after this? I am so sared , but I also dont want to submit her to pain longer than I should if she wont outgrow this.Any hep wih this would be appreciated! Thanks, Lora
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Dear Lora :
Thank you for your question .
The timing of antireflux surgery is subjective and should be decided on individual basis.
In general the indications for fundoplication include :
1. esophageal stricture
2. Barret’s esophagus ( an absolute indication as this may end up in cancer )
3. Life-threatening apnea( cessation of breathing) and aspiration pneumonia
4. Large hiatal hernia
5. failure of maximal medical therapy and
6. severe esophagitis ( esophageal inflammation)
7. recurrent pneumonia , chronic lung disease, bronchospasm
8. failure to gain weight.
Most gastroenterologists now include proton pump inhibitors ( e.g. omeprazole) as a component of treating severe esophagitis and respiratory complications together with cisapride and H2-blockers.
The procedure itself is usually very successful in preventing vomiting.
Short term complications include early satiety , increased bloating and or retching. If you decide to do the surgery , talk to the surgeon about the long term complications he/ she most commonly encounters .
L.M.
Disclaimer : this information is for educational purposes only.
Keywords : fundoplication,indications*(surgery), infant GERD*(gastroenterology)
