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Gastroesophageal reflux in infancy and childhood.
Eugene Suwandhi1, Mimi N Ton, Steven M Schwarz
1Department of Pediatrics, Long Island College Hospital, Brooklyn, NY 11201, USA.
Pediatric Annals
|April 28, 2006
Summary
Gastroesophageal reflux (GER) is common in infants and usually benign. Diagnosis relies on history and physical exam, with medical or surgical options available for persistent symptoms.
Area of Science:
- Pediatric Gastroenterology
- Infant Health
- Digestive Disorders
Background:
- Gastroesophageal reflux (GER) is a frequent reason for pediatric consultations.
- While often benign and self-limiting in infants, GER can mimic more serious conditions.
- Accurate diagnosis requires distinguishing GER from metabolic disorders, pyloric stenosis, and intestinal rotation abnormalities.
Purpose of the Study:
- To outline the diagnostic and management principles for GER in pediatric patients.
- To emphasize the role of primary care providers in managing GER.
- To review therapeutic options, including lifestyle modifications, medical treatments, and surgery.
Main Methods:
- Review of clinical guidelines and literature on pediatric GER.
- Emphasis on diagnostic approaches including history taking and physical examination.
- Discussion of empirical and medical treatment strategies (PPIs, H2RAs) and surgical interventions.
Main Results:
- A thorough history and physical examination are typically sufficient for GER diagnosis.
- Behavioral or lifestyle modifications are initial management steps.
- Proton pump inhibitors (PPIs) and histamine H2-receptor antagonists (H2RAs) are effective medical therapies.
- Anti-reflux surgery remains an option for severe cases.
Conclusions:
- Successful GER management hinges on accurate diagnosis, informed use of studies, and consistent treatment.
- Primary care providers play a crucial role in educating families about GER.
- A step-up or step-down approach with medical therapy is often employed.