GI - Gas and Prilosec
Question
Is extreme gas associated with reflux? What treatment(s) can be used?
Answer of our experts
Gas is associated with reflux in many ways. Too much gas in the stomach, from air swallowing or from food, can result in reflux. Some patients swallow air nervously. Patients with psychomotor retardation swallow air for unclear reasons. Patients with pulmonary disease swallow air and people with reflux swallow air. Unfortunately, swallowing air causes distension that causes reflux or burping. So the reflux and air swallowing are related, but in only a minority of patients can treating the reflux improve the air swallowing
DP/TK 7-13-10
Approved byClinical Advisory Board (CAB)
Answer is checked and valid for
Recommendation(s)
Feeding and Dental Difficulties
R12
In every CdLS individual with prolonged and marked feeding difficulties, the multidisciplinary assessment (from healthcare workers across many disciplines) should consider (temporary) placement of a gastrostomy (surgical opening through the abdomen into the stomach) as a supplement to oral feeding.
R13
In individuals with CdLS who have recurrent respiratory infections, reflux and/or aspiration (breathing foreign objects into airways) should be ruled out.
R14
The palate should be closely examined at diagnosis. In case of symptoms of a (submucous) cleft palate, referral for specialist assessment is indicated.
R15
Dental assessment and cleaning should take place regularly; a more thorough dental examination or treatment under anaesthesia may be necessary.
Recommendation(s)
Reflux
R32
Consider always gastro-oesophageal reflux disease (GORD) in any individual with CdLS owing to its frequency and wide variability in presentation, which includes challenging behaviour.
R33
Modification of nutrition and proton pump inhibitors (PPI) are the first-line treatments of GORD. Anti-reflux medications need to be used to their maximum dosage. Surgical interventions for GORD should be limited to those individuals with CdLS in whom nutritional and medical treatments have been unsuccessful or airway safety is at risk.
R34
If GORD symptoms persist, endoscopy should be strongly considered whilst an individual with CdLS is still in paediatric care.
R35
Surveillance for Barrett’s Oesophagus needs to be discussed with and decided together with the family, balancing the potential gain in health and burden for the individual with CdLS.
