Can My Child Go To School With Vesicoureteral Reflux
The answer to this question depends on the severity of the symptoms. Remember, vesicoureteral reflux itself isnt disruptive to your childs day to day living, but the urinary tract infections can be. Although not contagious, your child may be in pain or have problems with constipation or incontinence. Meet with your healthcare provider to discuss options for returning to school and participating in playdates.
About The Kidneys And Urinary System
The urinary system gets rid of things that the body no longer needs, so that we can grow and stay healthy.
The kidneys are bean-shaped organs. They filter blood and remove extra water and waste in urine . Most of us have two kidneys, They are on either side of our spine , near the bottom edge of our ribs at the back.
The two ureters are long tubes that carry urine from the kidneys to the bladder.
The bladder is a bag that stores urine until we are ready to urinate. It sits down low in the pelvis.
The urethra is a tube that carries urine from the bladder to the outside of the body. When we urinate, the urine is pushed out of the bladder through the urethra, a tube leading to the outside of the body.
What Questions Should I Ask My Healthcare Provider
Have a conversation with your healthcare provider where you get answers to all of your questions about vesicoureteral reflux . Recommended questions include:
- Is this a UTI or VUR?
- Is this BBD or VUR?
- Will my childs primary VUR get better without treatment?
- Does my child also have kidney problems?
- Should I see a specialist?
- How will you treat my childs VUR?
- What are the consequences of untreated VUR?
- What can I do at home to improve my childs condition?
- Will this condition cause my child pain?
- How can I prevent a urinary tract infection?
- How can I prevent BBD?
- Should my other children be checked for VUR?
A note from Cleveland Clinic
Remember that vesicoureteral reflux isnt usually painful or life-threatening. It is manageable and treatments are usually successful. There is no way to prevent it, but still make sure to have your child drink plenty of water, get exercise and eat nutritious meals to maintain overall health.
Rely on your healthcare providers expertise. They will help diagnose and treat your childs VUR. Dont hesitate to contact them with questions and concerns and be open and honest about your childs symptoms, even if theyre awkward to talk about.
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How Common Is Vesicoureteral Reflux
About 1% to 3% of children have vesicoureteral reflux . There appears to be a hereditary link to the disorder. If one child in the family has VUR, theres a little more than a one in four chance that a sibling will also have the condition. If a parent had VUR, there is a one in three chance that their child will have VUR.
Primary VUR due to a shortened ureter
What Are The Signs & Symptoms Of Utis
Symptoms of a UTI can include:
- pain when peeing
- lower abdominal pain
- lower back pain or discomfort
UTIs also can cause kids to wet their pants or the bed, even if they havent had these problems before. Infants and very young children may only show nonspecific signs, such as fever, vomiting, or decreased appetite or activity.
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What Are The Symptoms
Many children with VUR donât have symptoms. But when they do, the most common one is a urinary tract infection caused by bacteria. UTIs might not always come with symptoms, but when they do, they could include:
- Strong urge to pee
If you see these UTI symptoms in your child, contact your doctor. If your child has a rectal temperature of 100.4 F or fever of 102 F, call your doctor at once.
Other symptoms for VUR may include:
- Trouble urinating
- Mass in the abdominal area
- Poor weight gain
How Do Doctors Diagnose Reflux And Gerd In Children
In most cases, a doctor diagnoses reflux by reviewing your childs symptoms and medical history. If the symptoms do not get better with lifestyle changes and anti-reflux medicines, your child may need testing to check for GERD or other problems.
Several tests can help a doctor diagnose GERD. Sometimes doctors order more than one test to get a diagnosis. Commonly-used tests include:
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How We Pass Urine
Urine is made in each kidney and then passes through its ureter to the bladder. The bladder fills up with urine, like a balloon. When it is full, it sends signals to the brain that tell the bladder muscles to push urine out through the urethra. This is how we pass urine .
As most people urinate , the end of each ureter that goes into the bladder squeezes tight. It acts like a one-way valve urine can go into the bladder, but cannot leave the bladder back up the ureter.
Reflux Nephropathy On Both Kidneys
If your child has scars on both kidneys , he or she will need long-term follow up. This includes:
- urine tests to check for protein and other substances in his or her urine if there is more protein than usual in the urine , this may be a sign of hyperfiltration, when there are fewer kidney filters working
- blood tests to measure his or her kidney function .
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Preparing For An Appointment
Doctors usually discover vesicoureteral reflux as part of follow-up testing when an infant or young child is diagnosed with a urinary tract infection. If your child has signs and symptoms, such as pain or burning during urination or a persistent, unexplained fever, call your child’s doctor.
After evaluation, your child may be referred to a doctor who specializes in urinary tract conditions or a doctor who specializes in kidney conditions .
Here’s some information to help you get ready, and what to expect from your child’s doctor.
Pain Typically Comes And Goes In Waves Which Is Intensified By The Ureters Contracting As They Try To Push The Kidney Stone Out
Kidney stones are understood to cause extreme pain that usually comes and goes several times a day. Symptoms of kidney stones may not appear till the stone begins to move down the ureters.
What are the kidneys? The kidneys are two organs whose significant functions are to remove waste products and excess fluid from the body and to produce hormones that manage blood pressure, red cell production, acid policy and to influence calcium, salt, potassium and other electrolyte metabolic process.
Where are the kidneys located? The kidneys are bean-shaped organs that are found versus the back muscles in the upper abdominal area. They sit opposite each other on both the left and right side of the body the right kidney, nevertheless, sits a bit lower than the delegated accommodate the size of the liver.
Feeling that your kidney pain comes and goes cannot be ignored. Kidney stones prevail urinary tract disorders. Kidney stones can form in your kidneys when normal substances in your urine end up being too concentrated.
When this takes place, solid product can stay in your kidney or may move down your urinary tract, ultimately losing consciousness of your body.
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When Treatment Doesnt Work
UTI is a fairly common illness, accounting for around 8.3 million doctor visits yearly in the United States alone. This is probably why most people just shrug it off as another harmless condition, and most of the time, theyre right not to worry. Generally, this genitourinary infection is non-complex and thus fairly easy to manage.
There are cases, however, when patients dont respond to the treatment. According to Erik Castle, MD, from Mayo Clinic, there are several factors that may predispose you to UTI, particularly if youre a woman. These are:
- kidney or bladder stones
How Will My Baby Be Treated For Kidney Reflux
- Ensuring she doesn’t become constipated. Constipation can put pressure on your baby’s bladder and stop it from draining properly . Give her plenty to drink, and check that her wee is pale. This is a sign that she’s well-hydrated, and therefore less prone to constipation .
- If you’re breastfeeding, keep going. Breastfeeding can help your baby’s immune system, and it protects her against constipation too .
- When you’re changing your baby’s nappy, be careful to clean from front to back, to lessen the chances of bacteria getting into her bladder .
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How Is Vesicoureteral Reflux Diagnosed
The most common imaging tests used to diagnosed vesicoureteral reflux include:
Ultrasound testing is usually done on:
- Infants diagnosed during pregnancy with urine blockage affecting the kidneys.
- Children younger than five years of age with a UTI.
- Children with a UTI and fever, called febrile UTI, regardless of age.
- Males with a UTI who are not sexually active, regardless of age or fever.
- Children with a family history of VUR, including an affected sibling.
- Children five years of age and older with a UTI.
People Tend To Feel A Soreness In Their Spine Especially After Eating A Large Meal Not Sitting Up Straight While Eating Can Worsen That So Make Sure Your Posture Is Correct And Dont Hunch Over
Another trigger for back pain can be peptic ulcer. A peptic ulcer is a sore in your stomach or the in the small intestines which can cause heartburn as well as radiation of pain to the back.
If you suffer from any type of indigestion including IBS then you may experience not only back pain but also pain between your shoulder blades.
Chest pain from acid reflux or acid content going up into the esophagus may radiate to your back between the shoulder blades as well as the lower back.
Upper back pain accompanied with symptoms such as nausea, heartburn, and burning sensation in the upper abdomen may be due to GERD. This pain may come and go depending on how well you control your acid reflux condition.
Its always best to see your doctor if you heartburn or GERD trigger intense or increased back pain that is not responding well to pain relief medication.
Need guidance on how to control and manage your acid reflux? Check out my Heartburn No More program
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What Treatment Does My Child Need For Urinary Reflux
Urinary reflux usually gets better by itself as your child grows, especially if it is mild.
The treatment aims to prevent UTIs while your child is young, when they can cause damage to the kidneys. Sometimes, your doctor may prescribe a small dose of antibiotics to prevent UTIs until the urinary reflux improves or gets better by itself.
In most children, no treatment is necessary and your childs doctor will monitor the growth and health of your childs kidneys with scans. This will depend on how severe your childs reflux is.
Regular urine tests may be necessary to make sure there is no infection present. If your child develops any symptoms of a UTI while on antibiotics, take them to your family doctor for an immediate urine test.
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How Is Vur Graded
VUR is graded according to the images obtained on a VCUG. The lower the grade of reflux the higher the chances are that it will resolve without surgery. It is possible to have VUR bilaterally and that the grades will be different.
Grade 1: This is the mildest form of VUR. The ureters appear normal in size and urine flows up into the ureter but not into the kidney.Grade 2: Urine travels all the way up the ureter and enters the part of the kidney where urine is collected before draining . The ureter is normal in size.Grade 3: Similar to grade 2 expect that the ureters and/or the renal pelvis look more full.Grade 4: Similar to grade 3 except that the ureter is grossly enlarged and the calyces of the kidney are more blunted.Grade 5: Most severe state of VUR. Similar to grade 4 plus the ureter is very full and tortuous .
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How We Care For Vesicoureteral Reflux
The Boston Childrens Hospital Department of Urology team takes a conservative approach to VUR. Most children will outgrow their VUR on their own, and we give them a chance to do just that.
Our main goal is to treat vesicoureteral reflux and prevent infections that might affect the kidneys and possibly cause kidney damage. Our specialists provide a comprehensive approach to the management of vesicoureteral reflux from initial diagnosis to treatment and follow-up care.
Kidney Infection Home Remedies
You can do some things at home to feel better while you have an infection:
- Drink plenty of fluids to flush out germs.
- Get extra rest.
- When you go to the bathroom, sit on the toilet instead of squatting over it, which can keep your bladder from completely emptying.
- Take a pain reliever with acetaminophen. Donât use aspirin, ibuprofen, or naproxen because these can raise your risk of kidney problems.
- Use a heating pad on your belly, back, or side.
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How Is Vesicoureteral Reflux Treated In A Child
Treatment will depend on your childs symptoms, age, and general health. It will also depend on how severe the condition is.
VUR can be mild or more serious. It can cause mild reflux, when urine backs up only a short distance in the ureters. Or it can cause severe reflux leading to kidney infections and permanent kidney damage. Your child’s healthcare provider may assign a grade from 1 to 5 to show the degree of reflux. The higher the grade, the more severe the reflux.
Treatment depends on the grade of reflux:
Grades 1 to 3. Most children with grade 1 to grade 3 VUR dont need any type of intense therapy. The reflux goes away on its own over time, usually within 5 years. Children who have fevers or infections often may need to take antibiotic medicine and have periodic urine tests. They may also need surgery.
Grades 4 to 5. Children who have grade 4 or grade 5 reflux may need surgery. During the procedure, the surgeon will create a flap-valve device for the ureter. This will prevent reverse flow of urine into the kidney. In more severe cases, the scarred kidney and ureter may need to be removed.
New treatments are being introduced for VUR. Talk with your child’s healthcare provider for more information.
Talk with your childs healthcare providers about the risks, benefits, and possible side effects of all treatments.
How Is Vesicoureteral Reflux Treated
Many kids with primary VUR outgrow it. As a child gets older, the ureter gets longer and straighter, and in time will shut correctly.
Doctors use antibiotics to treat VUR that happens with a UTI. This keeps the infection from spreading to the kidneys. Kids who take antibiotics should take them for as long as prescribed, even if they start to feel better. Some kids will take antibiotics every day as a way to prevent VUR.
The doctor might talk to you about surgery that can help kids with moderate to severe cases of primary VUR with UTIs and fever. The most common type of surgery is ureteral reimplantation. In this procedure, the surgeon extends one or both ureters further into the bladder. This stops pee from flowing backward from the bladder to the ureters and kidneys. Kids who get this surgery usually spend a few days in the hospital while they recover.
Another surgery, endoscopic injection, involves injecting a special gel into the bladder through a thin tube. The surgeon places the gel into the opening of the ureter. This prevents pee from going back into the ureter and helps the ureter close properly. Most kids who have this procedure can leave the hospital on the same day.
Kids with secondary VUR might get to fight infections and treatment for the main problem that led to the VUR.
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What Can I Expect If My Child Has Vesicoureteral Reflux
Expect your child to endure one or more urinary tract infections and/or BBD . It is highly likely that your child will have UTIs first, and then later be diagnosed with vesicoureteral reflux . Most children outgrow the reflux completely, however some do not. These families work with their medical teams to come up with the best approach for their child.
Key Points To Remember
- Most children will outgrow vesicoureteral reflux .
- Children who have recurrent UTIs with high fevers should be evaluated for possible urinary tract problems such as vesicoureteral refluxusually with a renal bladder ultrasound and VCUG.
- Repeated UTIs with high fevers can lead to serious infections with potential to damage a childs kidneys.
- Diet does not cause VUR and cannot prevent it.
- If your child shows signs of scarring on the kidneys or diminished kidney function, surgery may be necessary to correct VUR.
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How Is Reflux Diagnosed Are There Signs To Alert Parents To The Problem
Usually, reflux is found when you take your child to the doctor after a urinary tract infection. About 50 percent of babies and 30 percent of older children with infections will have reflux. The back flow of urine to the kidney can cause a urinary infection to spread to the kidney, which can make your child very sick and can lead to kidney damage. You may notice that your child:
- goes to the bathroom more often
- says, “It burns” or “It hurts” when urinating
- says, “My stomach hurts”
Take your child to a doctor, who will get a urine culture if he or she suspects an infection.