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[Problems of gastroesophageal reflux in childhood]
Insights
Gastro-esophageal reflux in infants often resolves by age two, suggesting a delay in esophageal motor function maturation. Conservative treatment is recommended for most infants, with surgery reserved for severe cases or older children with complications.
Area of Science:
- Pediatric Gastroenterology
- Developmental Pediatrics
Context:
- Gastro-esophageal reflux (GER) is a frequent condition in infants.
- Most cases of infant GER resolve spontaneously within the first two years of life.
Purpose:
- To propose a hypothesis that infant GER stems from delayed maturation of central structures controlling esophageal motor function.
- To outline appropriate therapeutic strategies for infant GER based on age and severity.
Summary:
- The study hypothesizes that gastro-esophageal reflux in infancy is linked to delayed maturation of esophageal motor control.
- Conservative management is the primary approach for most infants.
- Surgical intervention may be necessary for severe cases, including those with neurological damage, esophageal atresia, failure to thrive, or esophagitis, and is the preferred treatment for older children with esophagitis or stenosis.
Impact:
- Highlights the importance of conservative management for typical infant reflux.
- Provides guidance on selecting appropriate treatments based on clinical presentation.
- Emphasizes the need for early surgical consideration in specific high-risk pediatric populations.
Abstract:
Gastro-esophageal reflux is common in infancy. However, in most of those children reflux disappears spontaneously at the end of the first year or during the second year of life. Thus, the authors suggest the hypothesis that gastro-esophageal reflux in infancy represents a delay in maturation of central structures for the motor function of the esophagus. Therefore conservative therapy during infancy is the treatment of choice for most of the infants. Additional factors however, such as severe cerebral or neurological damage, esophageal atresia, failure to growth and esophagitis make an early operative intervention often necessary. Likewise operative therapy is the treatment of choice in older children with symptoms of esophagitis or stenosis. Different diagnostic procedures are discussed briefly.