Diagnosis and treatment of gastro-oesophageal reflux disease in infants and children

Yvan Vandenplas, Badriul Hegar Syarif

Research output: Contribution to journalReview articlepeer-review

38 Citations (Scopus)

Abstract

Gastro-oesophageal reflux is a frequent, aspecific phenomenon in infants and children. The recommended approach in infants with uncomplicated regurgitation consists of reassurance of the parents and, if this fails, dietary recommendations in formula-fed infants. If, despite these efforts, symptoms persist, administration of prokinetics, such as cisapride, is recommended prior to investigations such as oesophageal pH monitoring. Oesophageal pH monitoring is also recommended to document gastro-oesophageal reflux disease in children with unusual presentations such as chronic respiratory disease. Today, cisapride is the drug of choice because it has the best efficacy and safety profile. In infants and children presenting with symptoms suggesting oesophagitis, endoscopy of the upper gastrointestinal tract is recommended. If there is severe oesophagitis, acid suppression with histamine H2-receptor antagonists or proton pump inhibitors in combination with prokinetics, are recommended. In life-threatening situations, or in patients that are resistant to or dependent on acid-suppressive medication, a surgical procedure such as laparascopic Nissen procedure should be considered. (C) 2000 Blackwell Science Asia Pty Ltd.

Original languageEnglish
Pages (from-to)593-603
Number of pages11
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume15
Issue number6
DOIs
Publication statusPublished - 1 Jan 2000

Keywords

  • Acid suppression
  • Antiregurgitation formula
  • Cisapride
  • Endoscopy
  • Gastro- oesophageal reflux
  • Oesophagitis
  • Prokinetic
  • Proton pump inhibitor
  • Regurgitation
  • Thickened formula
  • pH monitoring

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