Gastroesophageal reflux disease in infants and children

Abstract

GER is a normal, physiologic process that most commonly occurs in infants less than one year of age. However, GER may progress to GERD producing undesirable adverse effects and various complications. The pathophysiology of GER(D) is multifold, but it appears that transient decrease in LES tone is the most important factor. The diagnosis of GER can be made via a complete history and physical examination. A 24-hour pH probe is still considered the "gold standard" in the diagnosis of GER(D); however, other tests may be useful in assessing other complications of GER. Treatment should be approached in a stepwise fashion (i.e., lifestyle modifications, pharmacotherapy, and surgical procedures). H2-blockers, PPI and prokinetic agents are the most commonly prescribed medications in the medical management of GER(D).