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Gastroesophageal reflux disease beyond infancy
Yu-Cheng Lin1, Yen-Hsuan Ni, Mei-Hwei Chang
1Department of paediagastroesophagealtrics, National Taiwan University Hospital, Taipei, Taiwan.
Summary
Gastroesophageal reflux disease (GERD) is rare in children over one year old. Children with underlying conditions, particularly neurological impairment, experience persistent GERD, unlike those without such conditions.
Area of Science:
- Pediatric Gastroenterology
- Clinical Medicine
Background:
- Gastroesophageal reflux disease (GERD) is uncommon in children older than 12 months.
- Underlying medical conditions can prolong GERD from infancy into childhood.
Purpose of the Study:
- To compare the clinical outcomes of GERD in children over 12 months with and without underlying diseases.
Main Methods:
- A retrospective analysis of 34 children diagnosed with GERD between 1985 and 2000.
- Patients were categorized into two groups: those without underlying diseases (n=10) and those with underlying diseases (n=24).
- Diagnosis of GERD was confirmed by reflux symptoms and 24-hour esophageal pH monitoring.
Main Results:
- Underlying conditions included neurological impairment (n=14), repaired esophageal atresia (n=2), hiatal hernia (n=3), repaired congenital diaphragmatic hernia (n=2), and congenital heart disease (n=3).
- Nine out of ten children without underlying diseases achieved symptom resolution without further treatment.
- Ten out of fourteen children with neurological disorders had persistent reflux symptoms (P=0.02).
Conclusions:
- Neurological impairment and anatomical abnormalities (esophageal, diaphragmatic) are frequently linked to GERD in older children.
- Children with underlying diseases, especially neurological impairment, often have refractory GERD.
- Children without underlying diseases tend to have a longer symptom-free course.