Gastro Oesphageal Reflux, what is it? In its simplest and most basic of forms...
Let’s break it down into its simplest components –
Gastro means stomach,
Oesphageal is into the oesophagus
And reflux is involuntary regurgitation
It is simple - when something moves from the stomach into the oesophagus, a GOR event has occurred.
This process is completely normal, our bodies are designed to be able to do this for various reasons, for example getting rid of excess air from the stomach – or burping, and unwanted food or bacteria – vomiting. And as adults our bodies retain this capability as a means of supporting our digestive system and preventing attack from anything the body deems harmful such as viruses, bacteria and poisons.
So, yes, Gastro Oesphageal Reflux events are normal. Although this does not offer any solace to parents of babies who continue to suffer.
Our medics describe GOR Disease (GORD / GERD) as GOR that causes marked distress.
Let’s look at the definition from the Cambridge English Dictionary for disease.
(an) illness of people, animals, plants, etc., caused by infection or a failure of health rather than by an accident
Now I feel that this definition is wrong because GORD is not a disease. It is a dis-ease, a discomfort, but it has no underlying pathology and therefore is not an illness.
Sure, vomiting can be caused by an ingested virus, but this isn’t reflux disease, this is a stomach bug.
I also disagree with medical literature when it says that GORD is "normal". The ability to burp is normal, the ability to vomit is normal. When it happens on a continual and regular basis, with or without distress, it is notnormal.
For example, some babies vomit, a lot, and yet because they are not upset by it, and as a result they don’t gain as much weight as they should, or it causes distress to parents who often implement bigger feeding regime, yet the doctors will say that the vomiting is normal, and baby is gaining weight therefore it is not reflux disease. And without this label, both baby and parents are pushed away without answer and without support.
Yet even this constant vomiting worries parents, and I believe that this is not“normal”.
There is a reason for the frequent or constant vomiting and once we understand the reason we can resolve it.
So why does GOR happen? And why does it occur frequently?
It is very, very simple.
Grey’s Anatomy explained that reflux happens when the pressure in the stomach is greater than the pressure in the oesophagus.
We all know, that things tend to move from areas of high pressure to area of low pressure, they will naturally try to even things out. We see this every day in the changes in our weather. And we all know the sort of explosive force a build up of pressure in a small stretchy container can have…. Have you ever witnessed the bursting of a balloon? This is exactly the same mechanism at work in baby’s stomach.
When the pressure inside baby’s tummy is greater than the pressure in the oesophagus, and depending on how big that pressure difference is, that will determine the nature of the vomit that comes with it. Higher pressure results in projectile vomit and lower pressure presenting as silent reflux.
Now when these explosive events happen, what comes back into the oephagus can be just milk, or milk mixed with stomach acid. The longer the milk has been in babies tummy, the more acidic the reflux will be.
So what we need to understand then is what is causing the pressure in the stomach to be greater than the pressure in the oesophagus?
This is the solution.
Because the cause of reflux in infants is not an over production of acid in the stomach. It happens because there is too much air in baby’s tummy.
And I want to make a distinction here, a food allergy, such as CMPA, is not reflux, it is not caused by the same thing, it is actually caused by the stomach identifying the food as something it doesn’t think is safe and saying “I don’t want this in my body”, and then creating the gastro oesophageal reflux event to protect itself.
So while some of the symptoms and presentation my be the same, the cause is different. And this is why we really reallyneed to understand what is going on for our babies. So that we can help them, properly, and quickly. There is no reason that a baby who has a food allergy should be on reflux medications yet this seems to be the first place we go with babies presenting this way.
When we understand that out babies are telling us everything we need to know, through their symptoms and behaviours, we can understand virtually everything that is going on for them, and in most cases there are multiple causes of these reflux events. And with this information, we can take informed and appropriate action to help resolve the issues, and in many cases completely resolve their ongoing suffering and discomfort.
And the additional benefits – parents get to enjoy being parents, to get rest, reduce stress and reduced worry for their baby. These may be immeasurable things; they are massively meaningful.
If you want to learn more about reading the symptoms and behaviours that your baby is showing, to be able to help and resolve their reflux, then click here to enroll in my mini e-course on this topic. [PS - there's a free video in the "curriculum" section of this page to give you more information on the causes of reflux).
To get everything you need to know about how to manage your baby's reflux, silent reflux, colic or food allergies and intolerances, grab a copy of my book The Baby Reflux Lady's Survival Guide - your guide until your baby is over 2 with strategies to introduce food safely, understanding the differences with various formulas, what to do if your breastfeeding, tips on sleep for parents, detailed explanations of what mediations do and don't and much much more. Read about it here.