Diagnosis and management of gastroesophageal reflux in infants and children.
Use of histamine blockers, proton pump inhibitors, and prokinetic drugs, along with traditional antacids, has become standard therapy for gastroesophageal reflux (GER) in symptomatic adults. Response to this therapy is assessed to confirm the diagnosis of GER, and is often advocated as the best way to establish the causes and effects of the disease. It is well documented that reflux occurs throughout the life span. However, the incidence in children is difficult to estimate, requiring interpretation of behavior and symptoms in nonverbal and atypical presentations. Unfortunately, the diagnosis of GER in children is often made after the development of complications such as aspiration pneumonia, esophagitis, or ulcers. Early recognition and intervention by primary care providers is necessary to prevent such serious complications of untreated GER. This article presents the pathophysiology and clinical manifestations of GER. Diagnosis in children is discussed, and recommendations for empiric therapy, including conservative measures and drug therapies, are presented.
Ault
D L
DL
Undergraduate Nursing Program, Husson College, Bangor, Maine, USA.
Schmidt
D
D
D002648:Child; D002675:Child, Preschool; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000188:drug therapy / Q000451:nursing*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009722:Nurse Practitioners; D010353:Patient Education as Topic; D010371:Pediatric Nursing; D013664:Teaching Materials; D014481:United States