TY - JOUR
T1 - A narrative review of gastroesophageal reflux in the pediatric patient
AU - Jacobson, Jillian C.
AU - Pandya, Samir R.
N1 - Publisher Copyright:
© 2021 AME Publishing Company. All rights reserved.
PY - 2021/7
Y1 - 2021/7
N2 - Gastroesophageal reflux (GER) is the retrograde passage of gastric contents into the esophagus. It is a physiologic condition that is common in neonates, typically resolves spontaneously, and does not result in clinically significant complications. When pathologic, gastroesophageal reflux disease (GERD) can cause numerous complications including persistent emesis, failure to thrive, aspiration, and respiratory symptoms. While a diagnosis can often be made from a thorough history and physical, some patients may require further testing. In general, many clinicians will reserve extensive investigation such as multiple intraluminal impedance and pH monitoring for patients with a confounding clinical picture or relative contraindications to medical or surgical management. Whereas most pediatric GER resolves spontaneously, medical management including lifestyle changes, changes to feeds, and the use of H2-antagonists and/or proton pump inhibitors (PPIs) can be utilized to alleviate symptoms. Surgical treatment is reserved for patients who are refractory to medical management or have suffered significant complications as a consequence of GER. In this article we seek to provide a concise but detailed review of recent updates in the understanding, work up and management of GER in the pediatric patient. A summary of new technologies used in the diagnostic and therapeutic arms of this disease are included.
AB - Gastroesophageal reflux (GER) is the retrograde passage of gastric contents into the esophagus. It is a physiologic condition that is common in neonates, typically resolves spontaneously, and does not result in clinically significant complications. When pathologic, gastroesophageal reflux disease (GERD) can cause numerous complications including persistent emesis, failure to thrive, aspiration, and respiratory symptoms. While a diagnosis can often be made from a thorough history and physical, some patients may require further testing. In general, many clinicians will reserve extensive investigation such as multiple intraluminal impedance and pH monitoring for patients with a confounding clinical picture or relative contraindications to medical or surgical management. Whereas most pediatric GER resolves spontaneously, medical management including lifestyle changes, changes to feeds, and the use of H2-antagonists and/or proton pump inhibitors (PPIs) can be utilized to alleviate symptoms. Surgical treatment is reserved for patients who are refractory to medical management or have suffered significant complications as a consequence of GER. In this article we seek to provide a concise but detailed review of recent updates in the understanding, work up and management of GER in the pediatric patient. A summary of new technologies used in the diagnostic and therapeutic arms of this disease are included.
KW - Antacids
KW - Fundoplication
KW - Gastroesophageal reflux (GER)
KW - Gastroesophageal reflux disease (GERD)
KW - Nissen
UR - http://www.scopus.com/inward/record.url?scp=85111643731&partnerID=8YFLogxK
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U2 - 10.21037/tgh-20-245
DO - 10.21037/tgh-20-245
M3 - Review article
C2 - 34423155
AN - SCOPUS:85111643731
SN - 2224-476X
VL - 6
JO - Translational Gastroenterology and Hepatology
JF - Translational Gastroenterology and Hepatology
M1 - A4
ER -