Silent reflux does not exist

[pleasethanks]

Or so I have just been told by a doctor....My mind boggles! Can you please point me to respectable literature which says otherwise?

Good lord, is there no end to the bollocks GPs come out with...? Sorry, I don't have any literature, thankfully I found a sympathetic hcp when we had a silent reflux problem.
I'm sure someone will be along soon who can help. I just wanted to send you some empathy.

Such rubbish from your GP. There's a good post 25/1/10 you might want to look at. Suggest you get another opinion or go private if you can as there is no reason why you should be suffering such sleep deprivation and the agonies of a baby in pain. Good meds out there which will soon sort baby out: ranitidine and omeprazole. Keep baby as upright as poss especially after a feed - sling, tilt cot with books under legs at one end. Take all offers of help so that you can catch up on some sleep before you find yourself heading down the pn route due to tireness and anxiety.

Silent reflux is something I am unconvinced by, too. I don't blame any GP for saying it does not exist - it has very little respectable literature to support it as a treatable or worrisome pathology in babies.

I am not saying the condition never exists.

But I am saying it is often used as a 'diagnosis' instead of saying 'I don't know why your baby is crying'.

There have been cases on these boards where a mother has been told/wonders if her baby has 'silent reflux' and when she offers more cuddling and/or more feeding the condition has disappeared.

Tiktok, tt may be overdiagnosed but it definitely exists, and is not that uncommon I don't think. Both of my children have/ had it, DS 12 weeks is seeing a paed for it at the hospital, and a good friend's daughter has it to such a degree that she has chronic oesophagitis and has developed food aversions. She is now doing better on omeprazole.

Two or three cases do not a scientific case make, but where (silent) reflux is a problem, more cuddles and feeding may help comfort the baby but they will not fix the underlying problem - time and maturation of the digestive system will do that, and in the meantime medications can and do help many.

that should read it, as in silent reflux

narmada, honestly, I am not saying it does not exist, believe me.

I am saying I feel it may be over-diagnosed, and I have some sympathy with the doc because (unlike reflux without the 'silent') it is not a part of the 'respectable literature' in the OP's words...maybe it will get there in time.

I can add that with prem babies especially boys, it exists as the sats monitors show feeding correlates with difficulties which are not food related.

By way of illustration, my ds before he was on ranitidine, would be given a feed by NGT and within a second of being given it he would rapidly desaturate as his body couldn't cope with the acid and so it dealt with that by not breathing. Once on ranitidine his sats didn't drop anywhere near as low. Same milk, same volume, same tube.

Also silent relfux has a lovely effect on regurgitating milk through a babies nose.

None of which is to say that its not overdiagnosed, but to say it doesn't exist is too simplistic

These stories make me so thankful i had an understanding GP who referred us immediately. I know the difference in my baby the days i don't get the full does of omaprazole down her, or she sicks some up. I then have a screaming baby all day during and after feeds. Anecdotes don't make scientific proof i know, but i'm glad i have the means to make my baby pain free.

How old is your GP? Mine basically said the same thing and I would say she is in her 60s. I found the younger GPs much more clued up on it.

Silent reflux can (usually) be diagnosed with a barium swallow but its a pretty awful procedure for a small baby, which is why they don't do it.

I am very sure there are plenty of scientific studies on silent reflux in babies!

Thisisyoursong - honestly, there aren't.

I did a web of science lit search to check I was not talking out of my *rse, and while there are studies, they are mostly done on preterm babies (whose whole digestive tract is perforce immature) and on babies/children with a pre-existing known condition (I think one of them was cystic fibrosis), or on infants with an already inflamed oesophagus.

I do think diagnosis, assessment and treatment of otherwise healthy babies is a fairly new thing.

tiktok, I know - have seen your posts on other boards and you are always very measured and evidence-based. Perhaps you're right that it's overdiagnosed. For what it's worth, I am generally highly sceptical about things that don't appear to have a strong scientific evidence-base, like homeopathy etc. I have to admit I don't know about the medical or research literature on this one though.

If your baby does have GORD of the silent variety (not simple uncomplicated reflux), it can be so frustrating to be told over and over by medical professionals that it doesn't exist, or that it's just a variation of normal. It is so very hard to deal with as parents - there is the seeing your baby clearly in pain element, and also the continuous screaming, extreme sleep deprivation and where feeding difficulties exist, the feeling that you can't even nourish your infant properly. Having a baby with GORD turns your world upside down and not in a good way.

Interestingly, my DP has what would probably be correctly termed silent reflux. He is not vomiting everywhere, but does suffer a lot with regurgitation, heartburn, and has had a couple of episodes of oesophagitis too.

I am speculating on the basis that I see people wondering if their baby has silent reflux and people suggesting the baby might have it, when more simple things have not even been explored - this is what happens when a condition becomes sort of 'taken up'.

I should really shut up now, because I do believe it exists, and I don't want to suggest to mothers of babies with it that they are imagining things

It's not surprising that some GPs dismiss it though, as it takes a while for stuff to get properly and fully studied, and even longer to get into text books and training courses.

No, don't shut up, I do know what you mean. I am probably one of the suggesters you mention, I have definitely suggested it on these boards and perhaps I shouldn't as I am not an expert or medically trained

I do wish, though, someone had mentioned it as a possibility to me with my first DD - it could likely have saved her and us weeks of heartache.

www.utmb.edu/otoref/Grnds/Pedi-Gerd-0010/Pedi-Gerd-001025.htm

For a start (and this just took me two minutes to find) this article is over 10 years old, and references 29 published studies.

This is not a paper on silent reflux. It is on reflux. Silent reflux is mentioned, that's all.

Thisisyoursong - silent reflux exists. It does not appear to be well studied.

Gastric reflux = visible reflux.

Gastroesophageal reflux (GER or GERD) = silent reflux.

The title of the paper is:
PEDIATRIC GASTROESOPHAGEAL REFLUX

Maybe this is where we are talking in circles a bit? Perhaps you need to start looking up gastroesophageal reflux instead of silent reflux?

GERD is gastro-esophegeal reflux disease.

The terminologies are confusing, I agree.

But GERD and silent reflux are not necessarily the same. A google shows that US and UK definitions are not clear or consistent. What is accepted and understood and referred to in one way in one country is not the same in another.

I don't know why I am continuing this :) I believe the condition exists. It is crystal clear that there is no consensus on incidence, definition, treatment and seriousness.

But babies who have it, who really have it, are in discomfort, no doubt about that :(

OK, sorry I didn't realise there was some disagreement about what silent reflux actually is. But I do believe that for the most part (in the UK) people who are talking about silent reflux are talking about GERD, and its kind of splitting hairs to then say that there are not many studies done on silent reflux when there are plenty on GERD.

I do agree with you that it is overdiagnosed by parents, but not by GPs. And this doesn't explain why there are such wide gaps in GPs' knowledge. My GP said she knew that my DS didn't have reflux, as he didn't projectile vomit. To me that's unacceptable.

I do realise that it doesn't help there can be a range of gastric problems, intolerances etc which can have many different symptoms. But wouldn't more educated GPs eliminate the problem of it being overdiagnosed, as they would have more of an idea of the questions to ask and what the markers to look for are.