Diagnosing gastroesophageal reflux disease (GERD) in children

By: Daniel DiMeo, MD 

Pediatric gastroenterologist

When children have problems in their esophagus or moving food through their gastrointestinal tract, receiving an accurate diagnosis can be a challenge. At MercyOne, we have recently received EndoFLIP, a state-of-the-art minimally invasive diagnostic tool. This imaging technology allows us to look at the esophagus without requiring X-rays or radiation. MercyOne Children’s Hospital is the only hospital in the state of Iowa that uses EndoFLIP technology.

Symptoms

Gastroesophageal (GE) reflux in children can present in many ways. Some symptoms to look out for include:

• Vomiting
• Heartburn
• Feeding refusal
• Difficulty swallowing
• Drooling
• Chronic coughing especially when lying down
• Effortless regurgitation
• Unexplained irritability (especially in infants)

Why use EndoFLIP?

Compared to traditional diagnostic tests like an upper endoscopy (EGD), EndoFLIP allows simultaneous testing of the pressure and dimensions of the esophagus using a medical balloon mounted on a thin catheter. This can provide some information about swallowing. The technology uses an imaging technique called impedance planimetry to estimate the cross-section of the esophagus. EndoFLIP makes it much easier to diagnose and accurately characterize conditions such as esophageal stricture (tightening) and achalasia (food collects in esophagus).

How it works

When patients have trouble swallowing, there are complications with food and liquids moving from your mouth to your stomach. The medical term for this is dysphagia. For children who have this condition, often an upper endoscopy alone is not enough for a diagnosis. EndoFLIP measures the pressure and dimensions in the esophagus — giving the physician additional data to better diagnose esophageal disorders. Plus, EndoFLIP can be done together with an upper endoscopy, so it doesn’t require an additional appointment or sedation.

If you child has difficulty swallowing, we can help!

Need to see a pediatric gastroenterologist? Call 515-643-5454 and talk to your MercyOne primary care provider about a referral.