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Approach to Infants with GERD-like Symptoms
Begin by obtaining a detailed history, focusing on feeding patterns, regurgitation frequency, and associated symptoms such as irritability and poor weight gain. Conduct a thorough physical examination to identify signs of distress, such as arching of the back, fussiness during or after feeds, and respiratory symptoms. Rule out other causes of similar symptoms, including infections, metabolic disorders, and structural abnormalities. Evaluate the infant's feeding technique, assess for possible overfeeding or intolerance to certain formulas, and consider breastfeeding practices. Implement non-pharmacological interventions, such as feeding position adjustments, smaller and more frequent feeds, and thickening of feeds with rice cereal. If conservative measures prove ineffective, consider acid-suppressing medications under the guidance of a pediatric gastroenterologist, taking into account potential risks and benefits.
About the Speaker
Dr Pandu Chouhan
Consultant Pediatric Gastroenterology, KIMS Hospital, Hyderabad
Worked as Assistant Professor in Rajshree Medical Research Institute (Sept 2021- May 2022) Total 6 years and 9 months experience (2015-2022) – 3 Years as Senior Resident and 3 Years as Junior Resident Performed more than 30 liver biopsies in children Performed more than 100 upper GI endoscopy and more than 30 Sigmoidoscopy / Proctoscopy Performed more than 50 EVL (Endoscopic Band Variceal Ligation) Performed 3 capsule endoscopies Performed more than 100 therapeutic paracentesis
Upcoming Case Discussions
Diabetic Polyneuropathy
Diabetic polyneuropathy is a common complication of diabetes mellitus, characterized by nerve damage throughout the body due to prolonged high blood sugar levels. Symptoms can vary widely, including numbness, tingling, burning pain, weakness, and loss of sensation, typically starting in the feet and gradually spreading to other areas. Diagnosis involves a thorough medical history, neurological examination, and nerve conduction studies. Management focuses on glycemic control through medications, lifestyle modifications, and pain management strategies such as analgesics, anticonvulsants, and antidepressants. Additionally, addressing risk factors such as smoking, hypertension, and dyslipidemia is crucial. Regular monitoring for complications such as foot ulcers and autonomic dysfunction is essential for preventing further nerve damage and improving quality of life.
H. pylori Treatment with PYELRA®: Best Practices
PYLERA® is a medication used for the treatment of Helicobacter pylori (H. pylori) infection, a common cause of stomach ulcers and gastritis. It contains a combination of three active ingredients: bismuth subcitrate potassium, metronidazole, and tetracycline. This combination works synergistically to eradicate H. pylori bacteria and reduce associated symptoms. Treatment with PYLERA® typically involves taking multiple capsules four times a day for a specified duration, as prescribed by a healthcare provider. It is important to follow the treatment regimen as directed and to discuss potential side effects
Management of Pulmonary Fibrosis
Pulmonary fibrosis is diagnosed through a combination of medical history, imaging studies (like high-resolution CT scans), pulmonary function tests, and sometimes lung biopsies. Treatment often involves medications such as corticosteroids, immunosuppressants (like azathioprine or mycophenolate), and antifibrotic drugs (such as pirfenidone or nintedanib) to slow disease progression and manage symptoms.Supplemental oxygen therapy is commonly prescribed to relieve shortness of breath and improve oxygen levels in the blood. This program combines exercise training, education, and breathing techniques to improve overall physical condition and quality of life. Patients with pulmonary fibrosis should receive vaccinations against influenza and pneumococcal pneumonia to reduce the risk of respiratory infections. In severe cases, lung transplantation may be considered for eligible patients to improve survival and quality of life. Treatments like nutritional support, psychological counseling, and palliative care can provide comprehensive support and symptom management.
Alcoholic Hepatitis: Management Strategies
Management of alcoholic hepatitis involves a comprehensive approach aimed at halting disease progression, managing symptoms, and promoting liver recovery. The cornerstone of treatment involves complete alcohol cessation to prevent further liver damage and promote healing. Patients often have malnutrition, so nutritional therapy with a focus on adequate protein intake and vitamin supplementation is crucial. Corticosteroids like prednisolone may be prescribed in severe cases to reduce liver inflammation and improve survival rates. In severe cases unresponsive to medical therapy, liver transplantation may be considered, although strict criteria must be met. Diuretics may be used cautiously to manage ascites while monitoring for renal function. Prophylactic measures such as beta-blockers may be used to reduce the risk of variceal bleeding.
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