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Infant Regurgitation and Pediatric Gastroesophageal Reflux Disease

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Pediatric Neurogastroenterology

Part of the book series: Clinical Gastroenterology ((CG))

Abstract

GER and GERD are frequent conditions in infants, children, and adolescents. Symptoms differ with age, although the main pathophysiologic mechanism, transient relaxations of the lower esophageal sphincter, is identical at all ages. Although infant regurgitation is likely to disappear with age, little is known about the natural evolution of pediatric GER and GERD. The majority of reflux episodes are weakly acid, but the majority of “esophageal” symptomatic reflux is likely to be acid related. Regarding “extraesophageal manifestations,” measurement of nonacid reflux may be more relevant. Symptoms of GER are not specific and not sensitive. There is no golden-standard diagnostic technique. Impedance in combination with pH-metry is likely to replace simple pH-metry in the future. Treatment of regurgitation and moderate reflux disease should focus on reassurance and dietary and possibly positional treatment. Medical therapeutic options usually involve inhibition of acid suppression, although not all reflux symptoms and disease are caused by acid reflux. Alginates or antacids are useful when immediate symptom relief is required. No currently available prokinetic drug is indicated in the treatment of childhood GERD. Laparoscopic fundoplication is the recommended surgical procedure in selected cases of particularly severe and chronic GERD.

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Authors and Affiliations

  1. Pediatrics, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium

    Yvan Vandenplas M.D., Ph.D.

  2. Paediatrics Department, Paediatric Gastroenterology Hepatology and Nutrition Division, Universitair Kinderziekenhuis Brussel, Brussels, Belgium

    Bruno Hauser M.D.

  3. Pediatric Gastroenterology Department, Universitair Kinderziekenhuis Brussel, Brussels, Belgium

    Thierry Devreker M.D.

  4. Pediatric Department, University of Insubria, Ospedale “F. Del Ponte”, Varese, Italy

    Silvia Salvatore M.D.

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  1. Yvan Vandenplas M.D., Ph.D.
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  2. Bruno Hauser M.D.
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  3. Thierry Devreker M.D.
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  4. Silvia Salvatore M.D.
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Correspondence to Yvan Vandenplas M.D., Ph.D. .

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Editors and Affiliations

  1. Sainte-Justine Hospital, Department of Pediatrics, Division of Pediatric Gastroenterology, Université de Montréal, Montreal, H3T 1C5, Québec, Canada

    Christophe Faure

  2. Nationwide Children's Hospital, Division of Pediatric Gastroenterology, The Ohio State University, Columbus, 43205, Ohio, USA

    Carlo Di Lorenzo

  3. Gastroenterology and Neural Development, University College London, Institute of Child Health, Great Ormond Street Hospital for Children, London, WC1N 1EH, United Kingdom

    Nikhil Thapar

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Vandenplas, Y., Hauser, B., Devreker, T., Salvatore, S. (2013). Infant Regurgitation and Pediatric Gastroesophageal Reflux Disease. In: Faure, C., Di Lorenzo, C., Thapar, N. (eds) Pediatric Neurogastroenterology. Clinical Gastroenterology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60761-709-9_30

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