Table 2.

Diagnostic criteria for IIMSO and GERD in the context of the patient presented (15)

Characteristics	IISMO	GERD	Patient Presentation/Complaints
Crying Patterns	Excessive crying any time of the day, generally increasing in the evening	Irritable and excessive crying within a few minutes of feeding possibly due to heartburn and acid reflux/abdominal pain.	The patient exhibited excessive crying and irritability; particularly following feeding. The patient had abdominal pain as demonstrated by abdominal muscle contractions
Postures, movements, positional preferences	Prolonged antalgic posture for the sake of comfort; asymmetric movements/activities; unilateral spinal hypertonicity; tactile defensiveness; spinal sensitivity in specific areas	Prefers to sit upright; dislikes the prone position and demonstrates mild arching related to feeding.	Demonstrated the arching posture in addition to exhibiting spinal sensitivity in certain areas. Tactile sensitivity to stimulation on the abdomen
Eating Behaviors	Feeding disturbance which may be related to suck dysfunction	Frequent, recurrent vomiting, regurgitation; re-swallowing; may bite lip, show acid burns on lip; retching, choking, frequent cough; tongue thrusting nipple or pacifier; occasional diaphoresis while feeding	Frequent recurrent vomiting and regurgitation in addition to feeding disturbances. The patient demonstrated suck dysfunction.
Digestive Disturbance	None or Unrelated	Occasional heme-positive stools or emesis; occasional failure to thrive	Patient has failure to to thrive
Other signs, Symptoms and Timing of Disorder	Restless sleep or may refuse to sleep supine; affective disorder common; condition does not tend to improve over time, but may change as infant gains more strength and control, distress may change to “control” behaviors, such as head banging.	Persistence after 12 weeks, resolves by 1 year; diagnosed most often with history. Tests are barium swallow, pH probe, upper GI endoscopy or gastric emptying studies (usually unnecessary). Rarely responds to medication under 2 years of age	Restless sleep along with non-responsiveness to medication.