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Gastroesophageal reflux

L Spitz1, E McLeod

  • 1Department of Paediatric Surgery, Institute of Child Health, University College London and Great Ormond Street Hospital for Children, UK.

Seminars in Pediatric Surgery
|December 5, 2003
PubMed

Insights

Gastroesophageal reflux (GER) in infants often resolves naturally. Gastroesophageal reflux disease (GERD) requires intervention when symptomatic or causing complications, with surgery indicated for severe cases or apnea.

Area of Science:

  • Pediatric Gastroenterology
  • Infant Health

Background:

  • Gastroesophageal reflux (GER) is common in infants, typically resolving by age one.
  • Gastroesophageal reflux disease (GERD) is diagnosed when reflux causes symptoms or pathological consequences.
  • GERD is frequently observed in infants with esophageal atresia or neurological impairments, where conservative treatments are often ineffective.

Purpose of the Study:

  • To outline the diagnostic methods for GER and GERD.
  • To describe current medical and surgical management strategies for infant GERD.
  • To identify key indications for surgical intervention in infant GERD.

Main Methods:

  • Diagnosis relies on upper gastrointestinal contrast studies, endoscopy, and pH monitoring.
  • Medical management includes antacids, acid reduction, and prokinetic agents.
  • Surgical intervention is considered for esophageal strictures, anatomical defects, or treatment failure.

Main Results:

  • Conservative treatment is often ineffective in neurologically impaired children and those with esophageal atresia.
  • Apneic episodes due to GER represent an absolute indication for early surgical intervention.
  • Medical therapies aim to manage symptoms and reduce acid production.

Conclusions:

  • GERD diagnosis and management require careful consideration of symptoms and potential complications.
  • Surgical intervention is reserved for specific indications, including failure of medical therapy and severe complications like apnea.
  • Early surgical intervention is crucial for infants experiencing apneic episodes secondary to GER.

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