Gastroesophageal reflux disease in infants. Myths and misconceptions, where is the evidence?

Area of Science:

• Pediatrics
• Gastroenterology

Background:

• Infantile gastroesophageal reflux (GER) is a common, typically self-limiting condition.
• Gastroesophageal reflux disease (GERD) occurs when GER causes severe symptoms or complications like failure to thrive.
• Misconceptions regarding GER/GERD diagnosis and management are prevalent.

Purpose of the Study:

• To clarify the distinction between physiological GER and pathological GERD in infants.
• To address common myths and misconceptions surrounding GER/GERD.
• To evaluate the appropriateness of current diagnostic and management practices for infant GER/GERD.

Main Methods:

• Review of existing literature on infantile GER and GERD.
• Analysis of diagnostic and therapeutic interventions commonly used in clinical practice.
• Identification of areas where evidence is insufficient or controversial.

Main Results:

• GER is a normal physiological process in most infants.
• GERD diagnosis requires significant symptoms or complications.
• Inappropriate investigations and medications are frequently used for suspected infant GER/GERD.
• Evidence supporting some common therapeutic interventions for GERD is limited or controversial.

Conclusions:

• Distinguishing GER from GERD is crucial for appropriate infant care.
• Current diagnostic and management strategies for infant GER/GERD are often suboptimal.
• Further research is needed to establish evidence-based guidelines for GERD management in infants.