2021-12-17 08:49:55
Esophagitis is a inflammation of the lining of the esophagus. It is most often linked to gastroesophageal reflux disease (GERD), a common condition in babies. Esophagitis remains quite rare in toddlers, but once spotted, it must be treated quickly.
What is esophagitis? What causes in the baby?
The medical term may cause concern, yet esophagitis is not as common as it seems. “Esophagitis is, as the suffix ‘itis’ mentions, a “inflammation” of the esophagusthat is to say from the part of the digestive tract located between the child’s mouth and stomach”, summarizes Dr. Bellaiche, pediatrician specializing in gastroenterology at the Robert-Debré hospital in Paris. An inflammation that can be caused by several everyday products and therefore several causes.
Peptic esophagitis, with acid reflux
It’s very far the most common cause esophagitis in babies. It involves a rising acid stomach fluid in the esophagus which irritates the child, several times a day, for example when he has gastric reflux after drinking her milk.
Thermal esophagitis
It’s still milk here, but rather its preparation. “Many parents heat their baby’s bottle in the microwave. But the heating may not be uniform throughout the bottle, even if the first drop of milk on your wrist seems to be at the right temperature,” adds the doctor. Too hot milk can irritate and also damage baby’s esophagus.
Caustic-related esophagitis
Esophagitis can also be the consequence of a caustic productor a household product, with a high pH (+ 13), ingested by the child. Rather serious and urgent caseall dangerous products should be kept out of the reach of children.
allergic esophagitis
Finally, it can also be an allergic cause, which is calledeosinophilic esophagitis due to the presence of a polymorphonuclear present in many allergies. Children and adults with this form of esophagitis require special care.
What are the symptoms of esophagitis in babies?
The pediatrician wants to be precise on this point: not all regurgitations are symptoms of esophagitis, quite the contrary. “In fact, almost all infants experience regurgitation but very few have esophagitis, parents should not worry too much, we have to get the message across, ”says the specialist. In other words, a baby who regurgitates and cries while taking his bottle does not mean that he has esophagitis. On the other hand, if in addition to heavy crying, you discover:
These are situations in which your pediatrician will more investigation to find out if it is esophagitis.
Is gastroesophageal reflux disease (GERD) synonymous with esophagitis?
The specialized pediatrician evokes a shortcut still too present, between immaturity of the system, GERD (gastroesophageal reflux disease) and esophagitis.
“We have long talked aboutimmaturity of the lower sphincter, in the lower esophagus (the cardia) to explain the baby’s reflux and acid reflux”, explains the pediatrician. ” Today we are more nuanced. In quantitative terms, imagine, a baby must drink 130 to 150 ml / kg of milk per day to meet its energy needs. It is enormous ! At this rate, the infant’s stomach is so distended thatpart of the milk is necessarily pressure on the sphincter responsible for GERD. And who says regurgitation sometimes says regurgitation of acidic gastric fluid at the same time. It is not an obligation, but sometimes it can give complicated reflux called oesophagitis”.
Almost all infants experience regurgitation, but very few experience esophagitis
When to worry? What to do ? When is it considered an emergency?
No need to be alarmed at the slightest regurgitation. However, in the case of GERD, as seen above, if you notice that your baby is not growing enough, this is a reason for consultation. If you perceive blood in his regurgitations, it is better to even go directly to the emergency room.
How is an infant diagnosed?
If the pediatrician suspects esophagitis, in the event of symptoms and the presence of blood in the regurgitation for example, the procedure provides for an additional examination: endoscopy under anesthesia.
“Using devices intended for children, and with a small camera, we look to see if the esophagus indeed contains small areas of ulceration. In this case, we practice small samples to see if they contain elements linked to inflammation”, specifies the pediatrician.
“The methods of carrying out the examination (outpatient or in hospital) and the type of sedation depend on the age, the gesture possibly performed, the geographical distance from the home. The examination is carried out in a child who has fasted for at least 6 hours.in a room dedicated to this activity, sufficiently heated, equipped with oxygen intake and resuscitation equipment”, specifies the FMC-HGE (French Association for Continuing Medical Training in Hepato-Gastro-Enterology) (source 1).
Treatment: how to treat and relieve esophagitis in babies?
In case of esophagitis in the baby, the treatment is drug. It consists of a antisecretory, a proton pump inhibitor given one month at full dose, followed by 15 days at half dose. The medicine prevents the lifts from being too acidic. “Not to mention the presence of his parents to reassure him, and soothe his tears,” adds the pediatrician. Nevertheless, the drug is not magic: “as long as there are regurgitations, the esophagitis can also come back”.
Will my child keep the after-effects of his esophagitis?
The pediatrician wants to be reassuring: “in France, there is not really any sequelae of esophagitis. Complications can happen if the child is not treated, but esophagitis is not asymptomatic. We quickly consulted a pediatrician and found the problem and the appropriate treatment,” says the doctor. There is therefore no no reason to worry afterwards.
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