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Clinical investigations from the RACP

Investigation of infants and children with vomiting

Alan Chong

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Abstract

Vomiting and regurgitation are very common presenting symptoms to the doctor and can cause great concern to both parents and doctors.

Key Points

  • Although some 50% of infants have regurgitation or vomiting as an isolated complaint, less than 5% have significant underlying disease.
  • Investigations should be tailored to confirm the suspected diagnosis, exclude complications of vomiting and make an assessment to assist management.
  • Healthy thriving infants with regurgitation or mild uncomplicated gastro-oesophageal reflux do not require any investigation.
  • Warning signs requiring investigation or referral include: bilious vomiting; persistent, severe or recurrent vomiting; and vomiting associated with abdominal pain, lethargy, failure to thrive or neurological signs.

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