Gastro-Oesophageal Reflux Disease (GORD)

Summary

Gastro-oesophageal reflux disease (GORD) occurs when stomach contents flow back into the oesophagus, causing discomfort and sometimes complications. The most common symptoms are heartburn and acid regurgitation, but some children may also experience symptoms like cough, laryngitis, or even dental problems.

To diagnose GORD, a therapeutic trial with proton-pump inhibitors (PPIs) is often used. An upper endoscopy may be necessary to evaluate for complications, especially if symptoms persist or if there are concerning signs like weight loss or anaemia.

Although many children improve with treatment, GORD tends to relapse when treatment is stopped, so ongoing management may be required to keep symptoms under control.

Diagnosis and When to Seek Help

The key symptoms of GORD include:

  • Heartburn (a burning sensation in the chest)
  • Regurgitation (the feeling of acid coming up the throat)
    Other signs that might point to GORD include:
  • Cough or laryngitis
  • Dental erosion
  • Asthma-like symptoms
    If your child experiences any of these symptoms frequently or if they don’t improve with over-the-counter medications, it’s important to seek medical advice. Your child may need a diagnostic trial with medication or further tests like an upper endoscopy to check for complications or other concerns.

Management

GORD is typically managed through a combination of lifestyle changes and medication:

  • Lifestyle modifications: This may include adjusting eating habits (e.g., smaller meals), avoiding certain foods (like spicy or acidic foods), and ensuring that your child doesn’t lie down immediately after eating.
  • Medications: Proton-pump inhibitors (PPIs) are commonly prescribed to reduce stomach acid production, offering relief from symptoms.
  • Ongoing treatment: GORD can relapse after treatment is stopped, so your child may need continuous management to control symptoms.

Follow-Up and Monitoring

If your child is diagnosed with GORD, regular follow-up appointments will help track progress and adjust treatment if needed. In some cases, complications such as oesophageal strictures (narrowing of the oesophagus), Barrett’s oesophagus, or even oesophageal cancer can develop, so it’s essential to monitor and manage GORD symptoms closely to avoid these risks.

If your child experiences persistent symptoms despite treatment, or if they show any of the alarm features mentioned (e.g., unexplained weight loss), further evaluation is essential to rule out more serious issues.

GORD can significantly impact your child’s comfort and health, but with the right treatment and monitoring, most children can manage the condition effectively.

History and Exam

Key diagnostic facto

  • presence of risk factors
  • heartburn
  • acid regurgitation

Other diagnostic factors

  • dysphagia
  • bloating/early satiety
  • laryngitis
  • globus

Risk factor

  • family history of heartburn or GORD
  • older age
  • hiatus hernia
  • obesity

Diagnostic Investigations

1st investigations to order

  • proton-pump inhibitor (PPI) trial

Investigations to consider

  • oesophagogastroduodenoscopy (OGD)
  • ambulatory pH monitoring
  • oesophageal manometry
  • combined impedance-pH testing

Emerging tests

  • endoluminal functional lumen imaging probe

Book an Appointment

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      Social and emotional functioning refers to a child’s ability to understand, express, and manage their emotions, as well as to interact effectively with others. These skills are fundamental for building positive relationships, developing empathy, and coping with the everyday challenges of growing up.

      Children who experience difficulties in social and emotional functioning may struggle with recognizing their own feelings or those of others, regulating emotional responses, or responding appropriately in social situations. This can lead to challenges such as anxiety, low self-esteem, difficulty making friends, or misunderstandings with peers and adults.

      In the school environment, social and emotional difficulties can impact a child’s engagement, cooperation, and overall learning experience. Emotional distress may manifest as withdrawal, irritability, or disruptive behaviour, which can further affect academic progress and peer relationships.

      Assessment of social and emotional functioning as part of a neuropsychological evaluation typically includes behavioural observations, standardized rating scales, and information gathered from parents, teachers, and sometimes the child. This comprehensive approach helps identify strengths and areas for support in emotional regulation, social skills, and adaptive behaviours.

      Understanding a child’s social-emotional profile allows for the development of tailored strategies to enhance emotional wellbeing, build resilience, and improve social communication. Early intervention and supportive environments can empower children to navigate their emotions more effectively, fostering confidence and meaningful connections. 

      At Offspring Health, we aim to provide transparent information about the costs involved in neurodevelopmental and educational assessments.

      Neuropsychological assessments typically involve multiple sessions that usually take between 8 and 16 hours in total, depending on the complexity and individual needs. Our hourly rate is $260, so the total cost typically ranges between $2,300 and $4,230.

      Fees generally cover:

      • Initial consultation and history gathering
      • Testing sessions where your child will complete various fun and interactive tasks
      • Liaison with schools or health professionals as needed
      • Comprehensive case analysis and report preparation
      • Feedback sessions with families and, where applicable, educators or other professionals

      Please note that standard neuropsychological assessments are generally not covered by Medicare. However, some assessments and therapy services may be funded through the National Disability Insurance Scheme (NDIS) for eligible participants. We recommend discussing funding options with your NDIS planner or support coordinator prior to booking. Private health insurance may offer partial rebates depending on your level of coverage.

      What’s the next step?

      Please phone reception for a discussion about your needs or email psychology@offspringhealth.com