Assessing children with chalasia: rule out gastroesophageal reflux

Chalasia, the regurgitation of gastric contents into the esophagus, is a common problem seen in infancy. In some cases, however, the symptoms can be more complex and extend beyond early infancy. In these infants and children, the pathologic condition of gastroesophageal reflux may exist. It can be a challenge to assess whether these patients require further investigation and treatment. This article outlines the difference between simple chalasia and pathologic gastroesophageal reflux. Information is given that enables the clinician to provide children and families anticipatory guidance regarding the medical workup and management of this problem. In addition, the article provides clinical algorithms to enhance the practitioner's understanding of the decision-making process involved in treating these patients.