oa SA Pharmaceutical Journal - Gastro-oesophageal reflux disease in paediatric patients : review
Gastro-oesophageal reflux (GOR) is a frequent and common phenomenon in humans, both in normal children and adults. GOR involves the involuntary regurgitation of gastric contents into the oesophagus. Most reflux episodes are physiological and self-limiting. Gastro-oesophageal reflux disease (GORD) is GOR associated with mucosal damage or symptoms severe enough to impair quality of life. Clinical presentation varies with age, but in infants symptoms and signs include mainly regurgitation, persistent crying, irritability, back-arching, feeding and sleeping difficulties. Complications include oesophagitis, bleeding, stenosis and, rarely, Barrett's oesophagus or adenocarcinoma. There is no "gold-standard" diagnostic technique at present but available modalities include barium radiography, scintigraphy, endoscopy with biopsies, pH-metry and impedance monitoring. A stepwise approach to treatment is advised according to the severity of the disease. Proton-pump inhibitors remain the treatment of choice in severe GORD.
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