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Gastroesophageal reflux in childhood: implications for surgical treatment
1Section of Pediatric Surgery, University of Oklahoma College of Medicine, Oklahoma City.
Insights
Gastroesophageal reflux in children is common. Esophageal pH monitoring aids diagnosis, with medical treatment as the first approach, followed by surgery if needed.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Motility Disorders
Background:
- Gastroesophageal reflux is a common condition in infants and children.
- Accurate diagnosis is crucial for effective management.
Purpose of the Study:
- To outline diagnostic and treatment strategies for pediatric gastroesophageal reflux.
- To highlight the role of esophageal pH monitoring and surgical intervention.
Main Methods:
- Review of diagnostic studies for gastroesophageal reflux.
- Emphasis on esophageal pH monitoring for accurate assessment.
- Discussion of medical and surgical treatment options.
Main Results:
- Esophageal pH monitoring is the most accurate diagnostic study.
- Medical, nonoperative treatment is the initial approach for uncomplicated cases.
- Fundoplication offers a high success rate when medical treatment fails.
Conclusions:
- Effective management of pediatric gastroesophageal reflux involves accurate diagnosis and tailored treatment.
- Esophageal pH monitoring is key for diagnosis.
- Surgical intervention like fundoplication is a viable option for refractory cases.
Abstract:
Gastroesophageal reflux is a frequent occurrence in infancy and childhood. When appropriate symptoms are present, accurate diagnosis and treatment assessment can be obtained by a variety of diagnostic studies, most accurately by esophageal pH monitoring. Medical, nonoperative treatment usually is indicated initially if no established complication or life-threatening symptoms exist. When medical treatment is insufficient, operative treatment with fundoplication can be performed with an acceptable complication rate and a high expectation of success.