Center for Digestive Health and Nutrition - Arnold Palmer Hospital for Children

Reflux Guidelines: Modest Changes Best for Most Infants

Admin — Mon, 06 May 2013 15:07:12 +0000

Two thirds of otherwise healthy infants spit up because of their physiology, and they should be treated not with medication but with modest lifestyle changes, such as altering their position during feeding. Medications should be reserved for infants who actually have gastroesophageal reflux disease (GERD), according to an American Academy of Pediatrics (AAP) clinical report.

Jenifer R. Lightdale, MD, MPH, from the Boston Children’s Hospital in Massachusetts;; David A. Gremse, MD, from the University of South Alabama in Mobile;; and the AAP’s Section on Gastroenterology, Hepatology, and Nutrition published the guidance for pediatricians online April 29 in Pediatrics.

During infants’ routine 6-month physician’s visit, one quarter of parents pepper pediatricians with questions about gastroesophageal reflux (GER), according to the authors. Indeed, parents are consulting pediatric specialists, and an increasing number of inappropriate prescriptions for proton pump inhibitors (PPIs) are being written to treat pediatric patients, the authors note.

The guideline authors encourage pediatricians to follow guidelines updated in 2009 by the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition, which would apply the most conservative approaches to the vast majority of infants and would reserve more aggressive treatments, including surgery, for children with intractable symptoms and risk for life-threatening complications.

“In the infant with uncomplicated recurrent regurgitation, it may be important to recognize physiologic GER that is effortless, painless, and not affecting growth,” the authors write. “In this situation, pediatricians should focus on minimal testing and conservative management. Overuse of medications in the so-called ‘happy spitter’ should be avoided by all pediatric physicians.”

At the heart of the guidelines is the pediatricians’ ability to distinguish typical spitting up from the more problematic GERD, in which vomiting is accompanied by such symptoms as irritability, weight loss, refusing to eat, coughing, or wheezing and is confirmed through a series of diagnostic tests.

The guidelines counsel older children and adolescents to avoid caffeine, chocolate, alcohol, and spicy food and note the benefits of chewing sugarless gum. For older children with heartburn, if [PPIs] are indicated, children should take the medicine 30 minutes before eating. However, the guidelines “strike a note of caution” about inappropriate PPI prescriptions, which may increase the risk for lower respiratory tract infections.

“It cannot be overemphasized that pediatric best practice involves both identifying children at risk for complications of GERD and reassuring parents of patients with physiologic GER who are not at risk for complications to avoid unnecessary diagnostic procedures or pharmacologic therapy,” the authors conclude.

Written by Diedtra Henderson

Pediatrics. Published online April 29, 2013.

Crohn’s and Colitis Walk

Mark Johnson — Thu, 06 Dec 2012 13:56:09 +0000

Have you signed up for the Orlando Take Steps Walk? This walk benefits the Crohn’s and Colitis Foundation of America, everything helps in finding a cure for Crohn’s Disease and ulcerative colitis. The walk will take place April 27,2013 at Lake Lily Park, the walk begins at 5:00pm. Please join us and register today.

13 Orlando Walk Flyer

First Patient to Undergo Colonic Manometry

Mark Johnson — Fri, 02 Nov 2012 14:36:54 +0000

7 year old Madison Hance spent her Halloween at Arnold Palmer Hospital for Children, but she did not let that stop her or the other young patients from enjoying Halloween treats. Madison and her family, who are from Palm Coast, appeared in the Daytona Beach News-Journal this week discussing her plans while staying at Arnold Palmer Hospital.

Madison was the first patient at Arnold Palmer Hospital to undergo Colonic Manometry, a procedure that will allow her doctors to finally identify a treatment plan for a motility disorder she has been battling since infancy. A motility disorder is one that affects the passage of food through the digestive tract. Food is moved through the intestines with a process of contractions called peristalsis. A motility disorder is diagnosed when this process is abnormal. Arnold Palmer Hospital for Children is the only hospital in the southeast to offer this procedure to children. Dr. Shaista Safder, a pediatric gastroenterologist at Arnold Palmer, has been her doctor for 3 years, and discusses her procedure.

Read the article about Madison and her stay at Arnold Palmer Hospital for Children.

Dr. Bornstein voted Patients’ Choice Physician

Mark Johnson — Tue, 11 Sep 2012 13:20:48 +0000

Congratulations to Dr. Bornstein! He has been recognized once more as an extraordinary physician by his patients. Over the course of 2012 hundreds of thousands of patient reviews were written and shared. Dr. Bornstein received near perfect scores and is being recognized for his outstanding quality of service and patient care.

Dr. Devendra Mehta and the Feeding Difficulty Center

john — Thu, 09 Aug 2012 14:20:28 +0000

Fifteen percent of all children, particularly under the age of five, have some sort of eating disorder. Food allergies are a major culprit but there are also other feeding issues around chewing, swallowing, or even finicky eaters. Dr. Mehta from the Center for Health and Nutrition discusses their Feeding Difficulty Center and the benefits it offers families that may have a child with feeding difficulties.

This center is the first in Central Florida and one of the largest of its kind in the state Florida. One of the strongest benefits of this center is that the physicians can evaluate, diagnose, and treat pediatric feeding issues all in one setting. The problem with feeding troubles is that they are hard to diagnose. A parent may start with a family doctor then get passed to a speech therapist and then to a GI or gastrointestinal doctor. All of this can be handled at our Feeding Difficulty Center sparing the runaround parents might get as they try to help their child.

Center for Digestive Health and Nutrition voted one of Nation’s Best!!

Mark Johnson — Wed, 20 Jun 2012 19:27:43 +0000

Arnold Palmer Hospital for Children’s Center for Digestive Heath and Nutrition was voted one of the top Pediatric Gastroenterology programs in the country. U.S. News and World Report 2012-2013 ranked us 31 out of over 178 children’s hospitals nationwide. Arnold Palmer Hospital for Children was the only hospital in Central Florida to be included in the rankings. We would like to congratulate our wonderful physicians and staff for helping us achieve this honor!

Children with IBD in School

Mark Johnson — Wed, 28 Mar 2012 18:33:41 +0000

New studies provide insight and information for children dealing with Inflammatory Bowel Disease and difficulty functioning while in school. Follow this link to the read the full article, and learn more ways to help your child. http://www.nationwidechildrens.org/news-room-articles/study-shows-children-with-ibd-have-difficulty-in-school-mostly-due-to-absences?contentid=99626

Crohn’s and Colitis Foundation Events!

Mark Johnson — Thu, 08 Mar 2012 21:52:02 +0000

The Crohn’s and Colitis Foundation has some exciting new events coming up soon! Take a look here at the details, dates and locations, so you can join! Crohn’s & Colitis Foundation Events

Congratulations to Dr. Bornstein!

Mark Johnson — Thu, 16 Feb 2012 14:44:41 +0000

We could like to congratulate Dr. Bornstein recipient of the Patient Choice Award for 2011! This award is determined by patients voting through the American Registry on their experience with an outstanding physician. This will be Dr. Bornstein’s fourth consecutive Patient Choice Award!

New Doctors Join Arnold Palmer Hospital’s Pediatric Specialty Practices

Mark Johnson — Thu, 15 Dec 2011 21:31:59 +0000

ORLANDO, Fla (August 5, 2011) – Two physicians have joined the Pediatric Specialty Practices Office at Arnold Palmer Hospital for Children.

Alejandro Jordan-Villegas, M.D. is the newest member of the Infectious Disease Practice at Arnold Palmer Hospital. He completed medical school and immunology training with honors from Universidad del Valle in Cali, Colombia and performed pediatric training at Miami Children’s Hospital.

Dr. Jordan-Villegas also completed a pediatric infectious diseases fellowship at the University of Texas Southwestern Medical Center in Dallas, Texas. He has research experience in malaria vaccine studies, and respiratory viral infections and their interactions with bacterial pathogens.

Karoly Horvath, M.D., Ph.D., joined the Pediatric Gastroenterology Specialty Practice at Arnold Palmer Hospital. Before coming to Orlando, he was the director of Nemours Celiac Center and the Gastroenterology Laboratory at A.I. DuPont Hospital for Children in Wilmington, Delaware.

Dr. Horvath is board certified in pediatric gastroenterology. He is a published author with numerous published articles and book chapters in a variety of gastroenterology topics. He has dedicated many years to research and has taught at the University of Maryland and Hahnemann University in Philadelphia.

Both doctors will be based at the Arnold Palmer Hospital Pediatric Specialty Practice located at 83 W. Columbia Street, Orlando, Fl 32806.

ARNOLD PALMER HOSPITAL for CHILDREN

Arnold Palmer Hospital for Children, supported by the Arnold Palmer Medical Center Foundation, is a 158-bed facility dedicated exclusively to the needs of children. Located in Orlando, Arnold Palmer Hospital provides expertise in pediatric specialties such as cardiac care, craniomaxillofacial surgery, emergency and trauma care, gastroenterology, nephrology, neurology, oncology, orthopedics, pulmonology and sports medicine. Visit www.arnoldpalmerhospital.com to learn more about all of our specialties.

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