Guide to Reflux & Silent Reflux

Guide to Reflux & Silent Reflux

‘Reflux’ is the general word used to describe what happens when the stomach contents move, without any effort, into the oesophagus (food pipe) and in some cases into the throat and out of the mouth.

Silent reflux describes the same method of stomach contents moving into the oesophagus, whereby it rises to a point and then falls again. This additional return journey of stomach fluids can be doubly uncomfortable for the baby.

“Bringing up food is a common physiological process that usually happens after eating in healthy infants, children, and young people. It is most common in babies – affecting 4 in 10 infants – but can happen to almost everyone at some point in their lives.”  NICE guidelines 2014.

Medical experts agree to define reflux in two parts:

  1. Healthy Infants, who without effort, regurgitate excessively (sicking up). This is called Gastro-oesophageal reflux (GOR)
 and is considered to be a normal occurrence that the infant will outgrow with time, the introduction of solid foods and management of  upright position as much as possible.
  2. A condition which occurs where the delicate tissues and mucous layers of the oesophagus are gradually affected by the constant back-flow of stomach fluids. This requires medical intervention and treatment and is called Gastro-oesophageal reflux disease (GORD).

The more common symptoms of reflux GOR and GORD are:
•    Crying in pain
•    Discomfort when feeding (arching, screaming, refusal)
•    Fussiness
•    Frequent vomiting or sicking up
•    Foul breath (smells sour and acidic)
•    Chronic Cough
•    Night-time cough
•    Poor sleep habits, frequent waking
•    Wet burps & Hiccups
•    Comfort feeding- constant feeding to alleviate pain
•    Food intolerance or allergy
•    Hoarse voice, sore throat
•    Poor Weight gain

Less common symptoms of reflux:
•    Aspiration
•    Recurrent pneumonia
•    Ear/nose/throat/sinus infections

Professor Mark Baker, Director for the Centre for Clinical Practice at NICE, said: “It can be difficult to differentiate between ‘normal’ episodes of reflux and more serious GORD, but new NICE guidelines will support medical professionals to make the correct diagnosis.”

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