Ped？atr？c Gastroesophageal Reflux D？sease: Cl？n？c, D？agnos？s And Treatment

Abstract Gastroesophageal reflux (GER) is defined as the involuntary retrograde passageof gastric contents into the esophagus with or without regurgitation or vomiting. GERis a normal physiologic process occurring several times per day in healthy infants.Gastroesophageal reflux disease (GERD) occurs when reflux of the gastric contentscauses symptoms that affect the quality of life or pathologic complications, such asfailure to thrive, feeding or sleeping problems, chronic respiratory disorders, esophagitis, hematemesis, apnea and apparent life-threatening events. A reflux symptomin children, unlike adults, varies according to age group. History and physical examination is the gold standard for the diagnosis of GERD. It is important to definewhich children have GERD to offer optimal treatment and to avoid costly and potentially invasive diagnostic testing. The recommendation on management ofGERD in children has always been a step-up approach, starting with parental reassurance, positional treatment, dietary recommendations, medical or surgical therapy. Atypical presentations, complicated GER or failure to response to empiric management are indications for further diagnostic evaluations