Premium
Diagnosis and treatment of gastro‐oesophageal reflux disease in infants and children
Author(s) -
Vandenplas Yvan,
Hegar Badriul
Publication year - 2000
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1046/j.1440-1746.2000.02169.x
Subject(s) - cisapride , medicine , reflux , gastro , regurgitation (circulation) , gastroenterology , nissen fundoplication , disease , ranitidine , endoscopy , esophageal disease , pediatrics , esophagus
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 H 2 ‐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.