Good questions!
There is about a 30% chance that the sibling of a refluxing patient also has
refluxGastroesophageal reflux disease
Gastroesophageal reflux in infants
Hiatal hernia repair
Reflux nephropathy
Vesicoureteral reflux. I would recommend that your sibs have a urinalyses and
renalAcute kidney failure
Addison’s disease
Adrenal gland biopsy
Adrenalectomy
Cancer - renal pelvis or ureter
Catecholamines - blood
Chronic renal failure
Dialysis
End-stage kidney disease
Kidney diet - dialysis patients
Kidney stones ultrasounds. If both are
normalNormal saline flush, then I would stop there (assuming no urinary tract infections). Some pediatric urologists recommend having formal voiding cystourethrograms (NOT nuclear cystograms as they do not give any anatomical information), but I think that in the absence of infections and having normal kidneys, there would not be an indication to treat. The eight month old is a bit more at risk if she has reflux, even if she has not demonstrated any UTI's. I would just follow her with frequent urine cultures.
As regards the nocturnal enuresis, from a social/psychological standpoint she probably benefit from treatment. She'll probably do well with an anticholinergic such as ditropan. A pediatric urologist if not her pediatrician should be able to handle this.
S.A.Liroff, M.D.