Gastroesophageal reflux in children.
Information accumulated in recent years has provided answers to some, but not all, of the questions related to reflux. The various clinical presentations of GER are well described, and its natural history, especially in young childhood, is known. A number of tests to detect reflux have been adapted for children, and there has been good standardization in the performance of these tests. Criteria for diagnosis of GER are quite accurate, although consensus as to how extensive an evaluation is needed has not yet been reached. Medical therapy for reflux is reasonably effective. A number of surgical procedures have negligible morbidity and are very effective in controlling reflux. In spite of these advances, a number of areas require further study. Development of methods that clearly allow one to show a causal relation between GER and respiratory symptoms is an area of major importance. Development of criteria that would quickly identify those patients who would not benefit from a prolonged course of medical therapy would allow one to avoid the perpetuation of symptoms associated with ineffective medical therapy. Recent studies of the use of medication to prevent reflux open an exciting new vista. In view of recent studies demonstrating changes in gastric motility in adult patients with reflux, studies designed to further explore this area are indicated. If one could determine whether the therapeutic effect of bethanechol chloride and metocolpramide are related to esophageal or gastric effects, more effective drug therapy for GER might be devised.
D000328:Adult; D001466:Barium Sulfate; D002648:Child; D004945:Esophagoscopy; D004947:Esophagus / Q000473:pathology / Q000503:physiopathology; D005336:Fiber Optic Technology; D005764:Gastroesophageal Reflux / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D005769:Gastrointestinal Motility; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008991:Monitoring, Physiologic / Q000379:methods; D011187:Posture; D012120:Respiration Disorders / Q000209:etiology; D013981:Tic Disorders / Q000209:etiology; D014839:Vomiting / Q000209:etiology
D001466:Barium Sulfate