• Paolo Quitadamo
  • Annamaria StaianoEmail author


Gastroesophageal reflux (GER) is defined as the passage of gastric contents into the esophagus. GER is a normal physiologic process occurring several times per day in healthy infants, children, and adults. Most episodes of GER in healthy individuals last <3 min, occur in the postprandial period, and cause few or no symptoms. Conversely, gastroesophageal reflux disease (GERD) is present when the reflux of gastric contents into the esophagus causes troublesome symptoms and/or complications. Distinguishing physiologic GER from GERD may often be tricky, especially in infants. Indeed, in the first months of life, GER usually underlies recurrent regurgitation and vomiting, mainly due to anatomic features and liquid feeding. These symptoms, along with persisting crying and irritability, are often a source of anxiety for parents. Clinicians should be aware that the vast majority of these spitting infants does not deserve diagnostic test, and GERD should be suspected only when alarm signs arise.

Unlike infants, children and adolescents do not usually experience any relevant symptom related to physiologic GER. Therefore, in these age groups symptoms such as vomiting, heartburn, and chest pain should not be overlooked, and a diagnostic work-up is advisable. Only in older children and adolescents, an empiric acid-suppressive trial may be recommended. Respiratory symptoms, such as cough, wheezing, and hoarseness, may also be associated with GERD, being sometimes the only “atypical” presentation of the disease.


Gastroesophageal reflux Gastroesophageal reflux disease Regurgitation Vomiting Irritability Heartburn Chest pain Typical GERD presentation Atypical GERD presentation Respiratory symptoms 


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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of Translational Medical Science, Section of Pediatrics, “Federico II”University of NaplesNaplesItaly
  2. 2.Department of PediatricsAORN Santobono-PausiliponNaplesItaly

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