Infants and children with gastro-oesophageal reflux disease

Gastro-oesophageal reflux disease (GORD) is a condition that affects more than half of all children. It is often difficult to diagnose, because the line between physiological and pathological GORD is very thin indeed. The signs and symptoms should be assessed according to the relevant age, and in younger children, it may be more difficult to diagnose, due to a lack of effective communication. Diagnosis relies on an accurate history provided by the parents or caregivers. Invasive diagnostic procedures, such as pH probe-testing, may be carried out to confirm the diagnosis. Initial management consists of dietary modifications, especially in physiological GORD, and as supplemental therapy, in pathological GORD. Pharmacological treatment consists mostly of H-2-receptor blockers, proton-pump inhibitors (PPIs) and pro-kinetic agents, although preference is given to the PPIs, due to their healing effects in erosive oesophagitis.