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Gastro-oesophageal reflux in children
1Emma Children's Hospital AMC, Amsterdam, The Netherlands.
Scandinavian Journal of Gastroenterology. Supplement
|January 1, 1997
Summary
Gastro-oesophageal reflux in children differs from adults, often resolving by age two. Treatment focuses on gastric thickening and positioning, with adult therapies used for complicated cases.
Area of Science:
- Pediatrics
- Gastroenterology
Background:
- Gastro-oesophageal reflux (GOR) in children presents unique challenges compared to adults.
- A significant portion of GOR episodes in infants stem from transient increases in abdominal pressure exceeding lower oesophageal sphincter (LOS) pressure.
Purpose of the Study:
- To outline the distinct pathophysiology and age-specific management of GOR in children.
- To differentiate GOR treatment in uncomplicated versus complicated pediatric cases.
- To address diagnostic challenges and potential complications of GOR in infants and children.
Main Methods:
- Review of pathophysiological mechanisms of GOR in pediatric populations.
- Analysis of age-dependent resolution of GOR-related abnormalities.
- Comparison of treatment strategies for uncomplicated GOR, complicated GOR, and related conditions like eosinophilic oesophagitis.
Main Results:
- The primary pathophysiological cause of GOR in children (increased abdominal pressure) typically resolves by 1.5-2 years of age.
- Conservative treatments like gastric content thickening and anti-Trendelenburg positioning are effective for uncomplicated GOR in young children.
- For complicated GOR, treatments mirroring adult protocols (H2 antagonists, proton-pump inhibitors) show similar efficacy.
Conclusions:
- GOR management in children under two years requires minimal intervention unless complications arise.
- Complicated GOR in children necessitates treatment comparable to adults, with effective pharmacological options available.
- While rare, serious complications like aspiration in infants and the need to consider food allergies in eosinophilic oesophagitis warrant attention.