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Gastroesophageal reflux in pediatrics; (patho)physiology and new insights in diagnostics and treatment

C M Loots1, M A Benninga, T I Omari

  • 1Pediatric Gastroenterology and Nutrition, Emma Children Hospital/, Academy Medical Centre, Amsterdam, The Netherland. c.m.loots@amc.nl

Minerva Pediatrica
|February 22, 2012
PubMed

Insights

Gastroesophageal reflux disease (GERD) in infants and children presents diagnostic and treatment challenges due to non-specific symptoms. This review explores current understanding, diagnostic methods, and interventions for pediatric GERD.

Area of Science:

  • Pediatric Gastroenterology
  • Gastrointestinal Motility Disorders

Background:

  • Gastroesophageal reflux (GER) is the passage of gastric contents into the esophagus.
  • GER disease (GERD) occurs when GER causes significant symptoms or complications.
  • Diagnosing and treating GERD in infants and children is complex due to overlapping symptoms with common infant issues.

Purpose of the Study:

  • To review the current understanding of GERD pathophysiology in pediatric populations.
  • To discuss clinical history assessment for diagnosing GERD in infants and children.
  • To explore advancements in diagnostic modalities and therapeutic interventions for pediatric GERD.

Main Methods:

  • Literature review focusing on (patho)physiology, clinical presentation, diagnostics, and treatments of GERD in infants and children.
  • Analysis of current diagnostic criteria and their limitations for pH-metry, pH-impedance monitoring, and endoscopy.
  • Evaluation of non-pharmacological and pharmacological treatment strategies.

Main Results:

  • GERD symptoms like irritability, crying, and regurgitation are common in infants and not specific to GERD.
  • Objective diagnostic criteria for GERD using pH-metry, pH-impedance, and endoscopy are poorly defined.
  • The review synthesizes current knowledge on GERD management in children.

Conclusions:

  • Accurate diagnosis of GERD in infants and children remains challenging.
  • Further research is needed to refine diagnostic criteria and optimize treatment strategies.
  • A comprehensive approach considering pathophysiology, clinical evaluation, and therapeutic options is crucial for managing pediatric GERD.

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