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Gastroesophageal reflux (GER) in preterms: current dilemmas and unresolved problems in diagnosis and treatment

Nilgün Kültürsay1

  • 1Division of Neonatology, Department of Pediatrics, Ege University Faculty of Medicine, Izmir, Turkey. nilgun.kultursay@ege.edu.tr.

The Turkish Journal of Pediatrics
|May 23, 2013
PubMed

Insights

Gastroesophageal reflux (GER) is common in preterm infants, but diagnosis is challenging due to nonspecific symptoms and technical limits. Current GERD therapies lack proven efficacy and safety in this population, necessitating careful risk-benefit consideration.

Area of Science:

  • Pediatrics
  • Neonatology
  • Gastroenterology

Background:

  • Gastroesophageal reflux (GER) is a common physiological event in preterm infants.
  • Diagnosis of GER is often difficult due to nonspecific clinical signs and symptoms, as well as technical limitations.
  • Currently available GERD treatments lack proven efficacy and safety in preterm infants.

Purpose of the Study:

  • To review the challenges in diagnosing GER in preterm infants.
  • To evaluate the current understanding of GERD therapy efficacy and safety in this population.
  • To discuss preventive measures and treatment options for GERD in preterm infants.

Main Methods:

  • Literature review of studies on gastroesophageal reflux and gastroesophageal reflux disease in preterm infants.
  • Analysis of diagnostic challenges and limitations.
  • Evaluation of existing and proposed therapeutic interventions, including positioning, feeding modifications, and medical treatments.

Main Results:

  • GER is a common, yet difficult to diagnose, condition in preterm infants.
  • No current GERD treatment has demonstrated proven efficacy or safety in this population.
  • Preventive measures, such as specific infant positioning, are recommended, but require careful consideration for discharge.
  • Feeding modifications and probiotics are proposed treatments, while surgery is rarely indicated.

Conclusions:

  • Clinicians must carefully weigh the risks and benefits of GERD therapy in preterm infants.
  • Preventive strategies should be the primary approach.
  • Further systematic studies are needed to establish safe and effective GERD treatments for preterm infants.

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