Gastro-oesphageal reflux disease in infants

Abstract

Gastro-oesophageal refl ux (GOR) is a frequent and common phenomenon in humans, also in normal children and adults. GOR involves the involuntary passage of gastric contents into the oesophagus. Most refl ux episodes are physiological and self limiting. Gastro-oesophageal refl ux disease (GORD) is refl ux associated with mucosal damage or symptoms severe enough to impair quality of life. Clinical presentation varies with age but in infants includes mainly regurgitation, persistent crying, irritability, backarching, feeding and sleeping diffi culties. Complications include oesophagitis, bleeding, stenosis and rarely Barrett’s oesophagus or adenocarcinoma. There is no ‘gold-standard’ diagnostic technique available but available modalities include radiography with barium, scintigraphy, endoscopy with biopsies, pH metry and impedance monitoring. A stepwise approach of treatment options available should be used according to the severity of the disease. Proton pump inhibitors remain the treatment of choice in severe gastro-oesophageal refl ux disease.