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Updated: Oct 23, 2025
Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring
Published on: December 14, 2020
A narrative review of gastroesophageal reflux in the pediatric patient
Jillian C Jacobson1, Samir R Pandya1,2
1The University of Texas Southwestern Medical Center, Dallas, TX, USA.
Insights
Gastroesophageal reflux (GER) is common in infants and usually resolves on its own. Gastroesophageal reflux disease (GERD) requires management for complications, with recent updates in pediatric diagnosis and treatment.
Area of Science:
- Pediatric Gastroenterology
- Neonatal Medicine
- Digestive Health
Background:
- Gastroesophageal reflux (GER) is the normal retrograde passage of gastric contents into the esophagus, common and typically self-limiting in neonates.
- Pathologic gastroesophageal reflux disease (GERD) can lead to serious complications like failure to thrive, aspiration, and respiratory issues.
Purpose of the Study:
- To provide a concise review of recent advancements in the understanding, diagnosis, and management of GER in pediatric patients.
- To summarize new diagnostic and therapeutic technologies for GERD in children.
Main Methods:
- Review of current literature and clinical practices regarding pediatric GER and GERD.
- Inclusion of information on emerging diagnostic tools like impedance and pH monitoring.
- Discussion of medical and surgical management strategies.
Main Results:
- GER is a physiologic condition in neonates, but GERD necessitates intervention due to potential complications.
- Diagnosis often relies on history and physical examination, with advanced testing reserved for complex cases.
- Medical management (lifestyle, feeds, medications like PPIs) and surgery are key treatment modalities.
Conclusions:
- Most pediatric GER resolves spontaneously, but GERD requires careful management.
- Updates in diagnostic and therapeutic technologies are enhancing the care of pediatric GERD.
- A comprehensive approach combining clinical evaluation and appropriate interventions is crucial for managing pediatric GERD.
Abstract:
Gastroesophageal reflux (GER) is the retrograde passage of gastric contents into the esophagus. It is a physiologic condition that is common in neonates, typically resolves spontaneously, and does not result in clinically significant complications. When pathologic, gastroesophageal reflux disease (GERD) can cause numerous complications including persistent emesis, failure to thrive, aspiration, and respiratory symptoms. While a diagnosis can often be made from a thorough history and physical, some patients may require further testing. In general, many clinicians will reserve extensive investigation such as multiple intraluminal impedance and pH monitoring for patients with a confounding clinical picture or relative contraindications to medical or surgical management. Whereas most pediatric GER resolves spontaneously, medical management including lifestyle changes, changes to feeds, and the use of H2-antagonists and/or proton pump inhibitors (PPIs) can be utilized to alleviate symptoms. Surgical treatment is reserved for patients who are refractory to medical management or have suffered significant complications as a consequence of GER. In this article we seek to provide a concise but detailed review of recent updates in the understanding, work up and management of GER in the pediatric patient. A summary of new technologies used in the diagnostic and therapeutic arms of this disease are included.
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