Gastroesophageal reflux in children: To treat or not to treat?

Abstract

Gastroesophageal reflux (GER) is a common functional gastrointestinal disorder in children. It most often occurs in the first year of life and in most infants it disappears spontaneously by the time they are 12 months old. One in ten infants with GER will continue to suffer after the first year, with the possibility of developing a chronic course. In children, GER is often associated with certain pathological conditions that predispose to it, such as prematurity, obesity, neurological damage, esophageal diseases, respiratory diseases and similar. These children are at increased risk for developing gastroesophageal reflux disease (GERD). Symptoms and signs of GER are not specific only to the gastrointestinal tract, but may also include general, respiratory, otorhinolaryngeal, and neurological disorders. If left untreated, GERD can lead to life-threatening complications for the child. If GER interferes with the patient's daily functioning due to the appearance of alarming signs and complications, we speak of gastroesophageal disease. The treatment of GERD belongs to the domain of primary health care pediatricians, and in the case of GERD, the child should be referred to a pediatric gastroenterologist.