Suggested Pre-Referral Evaluation and Management Guidelines
Red Flags: weight loss, bilious vomiting, hematemesis, and/or apnea/cyanosis.
If no red flags, in children 2 months & older, Proton Pump Inhibitor:
Zantac 3mg/kg/dose BID or 2 mg/kg/dose TID in infants. If the child is irritable, can use a proton pump inhibitor
solu-tab Prevacid for younger children (not the liquid form, Zegerid), taken 20-30 minutes prior to breakfast on an empty stomach. 1mg/kg/day
NOTE: Zantac (or other H-2 antagonists) and proton pump inhibitors are antacid medications and are unlikely to have any impact on the regurgitation or spitting. There is not currently a safe and effective prokinetic medicine.
Suggested Additional Test/Management Prior to Specialty Visit
Upper GI to rule-out anatomical abnormalities or ultrasound to rule-out pyloric stenosis, if clinically indicated.
3 months, sooner for Nurse Practitioners (typically 1-2 months)
How to Get Results to Consultant
UMHS Patients: See MiChart
External Patients: Fax records to 734-763-7359 prior to appointment.
A referral from the primary care physician is required prior to the appointment. Consult for a second opinion requires approval by a staff Pediatric Gastroenterologist. The covering staff physician may be reached by M-line.
It is helpful for us to have records of any prior laboratory studies, x-rays, prior endoscopy reports, other test results, or hospitalizations. Having the child's growth record (obtained from their primary care clinician) is very helpful.
Clinic Contact Information
Physicians: 734-763-9650 or M-Line 734-936-3856