Arrangementsbeskrivelse

The symposium´s aim is to broaden the participants view on reflux – from different profession´s perspectives.

The Program:

Infant Gastroesophageal reflux (benign infant acid reflux) or plain aerophagia due to Tethered Oral Ties (TOTS)
Presenter: Dr. Lawrence Kotlow, Pediatric dentist, Albany New York
Abstract: Physicians are often asked to diagnose and treat infants with clinical signs of gastroesophageal reflux (GER) symptoms and in extreme cases gastroesophageal reflux disease (GERD). Some infants are left to work out their pain, regurgitation and vomiting until they outgrow the symptoms while others may undergo expensive, invasive endoscopic procedures in the operating room under general anesthesia.
Initial treatment is often for infants to be placed on prescription adult acid reflux medications, which have limited benefits. Drugs prescribed include:H-2 blockers such as ranitidine (Zantac), a proton pump inhibitor such as omeprazole (Prilosec) or lansoprazole (Prevacid).
TOTS may cause aerophagia, a condition where the infant’s latch onto the mother’s breast or bottle allows the infant to swallow excessive amounts of air into the stomach during feeding. This aerophagia may be responsible for symptoms mimicking GER or GERD.
When these infants are examined for symptoms of GER the differential diagnosis of tethered oral tissues (TOTS) may not be addressed. [3] Tethered oral tissues may involve ankyloglossia (tongue-tied), maxillary and /or mandibular frenum lip-ties and in some instances buccal frenum ties. These tethered oral tissues (TOTS) prevent the infant from achieving a good seal onto the breast and or bottle with the resulting ingestion of excessive amounts of air.

Gastroesophageal reflux disease in infants – per definition a challenging diagnosis
Presenter: Dr. Maartje Singendonk, postdoctoral fellow at the department of Pediatric Gastroenterology and Nutrition of the Emma Children’s Hospital, Amsterdam UMC, Holland
Abstract: Gastroesophageal reflux disease (GERD) represents the most common disorder that leads to referral to a paediatric gastroenterologist during infancy. In infants, GERD symptoms are aspecific (e.g. crying and regurgitation) and the extent to which these symptoms are considered part of normal physiology or the GERD spectrum is often unclear from history alone. Despite several diagnostic tests for GERD being available, all were shown to correlate poorly with symptomatology in infants nor are they able to predict the occurrence of complications (e.g. erosive esophagitis, iron deficiency anaemia, growth failure and failure to thrive). It has thus been extremely challenging to diagnose GERD in infancy. Speaker: Dr. Maartje Singendonk, postdoctoral fellow at the department of Pediatric Gastroenterology and Nutrition of the Emma Children’s Hospital, Amsterdam UMC, Holland

When to treat and when not to treat gastroesophageal reflux disease in infants
Presenter: Dr. Maartje Singendonk, postdoctoral fellow at the department of Pediatric Gastroenterology and Nutrition of the Emma Children’s Hospital, Amsterdam UMC, Holland
Abstract: Historically, the focus of GERD treatment was on reducing acid burden, which resulted in a dramatic increase in prescription of proton pump inhibitors (PPIs). However, accumulating evidence shows PPIs to be ineffective in the reduction of GERD symptoms in infants. Furthermore, concerns regarding their safety and effects on the developing gut microbiome have recently been highlighted.
Current guidelines advice to be hesitant with treatment – but how do we manage patients in clinical practice? In this presentation the different treatment options for GERD symptoms in infants will be discussed as well as their limitations and potential side-effects.

Reflux and Oral Ties…
Presenter: Dr. Kirsten Slagter DDS, PhD, Dentist/ Implantologist, Holland
Abstract: The literature suggests that oral ties and reflux symptoms can be related. This presentation will give an update about the literature regarding this matter and what the current knowledge is about reflux and oral ties. The preliminary results of the “BRIEF” study (Breastfeeding and Reflux Improvement, the Effect of Frenulotomy) will also be discussed. This prospective study is a cooperation between the Tongue Tie Clinic and the University Medical Centre Groningen following 150 breastfeeding mothers with their babies.

The osteopathic approach to gastroesophageal reflux (GER) & gastroesophageal reflux disease (GERD) in infants
Presenter: Didde Thorsted, Licensed Physiotherapist, Naturopath, Osteopath DO. M.R.O. DK & DPO.  
Abstract: Presentation of the empirical considerations behind the osteopathic treatment of GER & GERD.

Combining knowledge from embryology, neurology, anatomy and physiology, this presentation focusses on how to implement an osteopathic treatment strategy and choice of techniques when treating GER & GERD. 

A Family´s nightmare 
Presenter: Insights in a Danish family´s history concerning 2 children with reflux causes by tethered oral tissues (TOTS) 
Abstract: Mie K. Lehm Mikkelsen, parent, Occupational therapist and OMFT therapist, Denmark