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A primary care approach to pediatric gastroesophageal reflux
B Sunku1, R V Marino, R Sockolow
1Department of Pediatrics, Winthrop-University Hospital, Mineola, NY, USA.
Insights
Gastroesophageal reflux, a common issue in children, involves stomach contents flowing back into the esophagus. Gastroesophageal reflux disease (GERD) requires medical or surgical treatment when complications arise.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Motility Disorders
Background:
- Gastroesophageal reflux (GER) is prevalent in pediatric patients, characterized by the retrograde passage of gastric contents into the esophagus.
- Transient lower esophageal sphincter relaxations are considered a primary cause of GER.
- Infants typically exhibit regurgitation, while older children may present with esophagitis.
Purpose of the Study:
- To review the pathophysiology, diagnosis, and management of gastroesophageal reflux disease (GERD) in the pediatric population.
Main Methods:
- Review of current literature on GERD in children.
- Discussion of diagnostic tools including barium swallow, pH probe, scintigraphy, and endoscopy with biopsy.
- Overview of medical and surgical treatment options.
Main Results:
- GERD can manifest with significant respiratory symptoms and pathological esophageal changes.
- Diagnostic procedures aid in assessing the severity and impact of GERD.
- Management strategies include pharmacotherapy (prokinetic agents, acid suppression) and, less commonly, surgery.
Conclusions:
- GERD is a condition with potential severe consequences in children, necessitating accurate diagnosis and tailored treatment.
- Both medical and surgical interventions play a role in managing pediatric GERD.
Abstract:
Gastroesophageal reflux is a common problem that occurs in the pediatric population. Gastroesophageal reflux refers to the retrograde passage of gastric contents into the esophagus. Current thinking implicates transient lower esophageal sphincter relaxations as a major cause for reflux. Infants generally present with symptoms of regurgitation, whereas symptoms of esophagitis are more common in older children. When there are dangerous consequences secondary to gastroesophageal reflux, it is termed gastroesophageal reflux disease (GERD). GERD has been shown to manifest with respiratory symptoms and a pathologic process. A variety of diagnostic procedures are available for the assessment of GERD which include barium swallow, pH probe, scintigraphy, and endoscopy with esophageal biopsy. Medical management of GERD primarily involves prokinetic agents and acid suppression therapy. Surgical therapy, albeit less common, now still has its role in the treatment of GERD.