We were discussing with an MO on atypical SSx of GERD whether projectile vomiting can occur in GERD.
Referring to Prof nasser notes during bms, increased intracranial pressure can cause projectile vomiting but the pathophysiology behind that is unclear.
GERD is mainly due to problem with antireflux barrier, primaryly lower esophagal sphincter. So increase in intrabdominal pressure can cause vomiting in GERD. But the classical symptoms of GERD is heartburn and epigastric pain.
Atypical symptoms are vomiting, dental enamel erosion, respiratory ssx, ear nose throat symptoms, n chest pain...chest pain unusual and nonspesific.
However, GERD can be associated be preceded / contributed by increased abdominal pressure which might lead to vomiting but symptoms are heartburn and dyspepsia. It is called as reflux esophagitis, not up to projectile vomiting.
GERD that presented with projectile vomiting are in small children & infant as the causes mainly underlying weak LES...the stomach is small and esophagus tract is shorter compared to adult...with the amount of food / fluid that the infant take. So it may reflux and shoot up as projectile. Nevertheless projectile vomit in children or infant with GERD is not that common & pyloric stenosis or obstruction have to be ruled out.
http://www.hon.ch/OESO/books/Vol_5_Eso_Junction/Articles/Images/140f1.jpg
http://www.hon.ch/OESO/books/Vol_5_Eso_Junction/Articles/Images/140f1.jpg
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