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Gastroesophageal Reflux

Gastroesophageal Reflux is a topic covered in the 5-Minute Pediatric Consult.

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Basics

Description

  • Effortless regurgitation of gastric contents; occurs physiologically, with episodes typically brief and asymptomatic
  • Divided into physiologic and pathologic processes:
    • Some degree of physiologic gastroesophageal reflux (GER) is normal at all ages.
    • Physiologic infant GER is very common. Symptoms peak around 4 months of age and generally have resolved by 1 year of age.
    • Pathologic reflux or GER disease (GERD) is defined by troublesome symptoms or complications of GER.
    • Complications of GERD may include reflux esophagitis, bleeding, esophageal stricture, failure to thrive, chronic/recurrent respiratory tract disease, or vomiting.

Epidemiology

Pathologic GERD occurs in 5% of adults; 1–4% of children

Risk Factors

  • Neurologic disorders (cerebral palsy/quadriplegia)
  • Congenital esophageal disorders
  • Midgut or diaphragmatic defects
  • Cystic fibrosis
  • Asthma
  • Gastroparesis
  • Hiatal hernia

Pathophysiology

  • Transient relaxation of the lower esophageal sphincter during episodes of increased abdominal and gastric pressure
  • GERD is a multifactorial process that is mediated by the number and frequency of reflux events, relative acidity, potential for esophageal clearance, delay in gastric emptying, effectiveness of mucosal barriers, degree of visceral hypersensitivity, and airway responsiveness.

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Citation

Cabana, Michael D., editor. "Gastroesophageal Reflux." 5-Minute Pediatric Consult, 8th ed., Wolters Kluwer, 2019. Pediatrics Central, peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617413/all/Gastroesophageal_Reflux.
Gastroesophageal Reflux. In: Cabana MD, ed. 5-Minute Pediatric Consult. 8th ed. Wolters Kluwer; 2019. https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617413/all/Gastroesophageal_Reflux. Accessed April 22, 2019.
Gastroesophageal Reflux. (2019). In Cabana, M. D. (Ed.), 5-Minute Pediatric Consult. Available from https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617413/all/Gastroesophageal_Reflux
Gastroesophageal Reflux [Internet]. In: Cabana MD, editors. 5-Minute Pediatric Consult. Wolters Kluwer; 2019. [cited 2019 April 22]. Available from: https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617413/all/Gastroesophageal_Reflux.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Gastroesophageal Reflux ID - 617413 ED - Cabana,Michael D, BT - 5-Minute Pediatric Consult UR - https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617413/all/Gastroesophageal_Reflux PB - Wolters Kluwer ET - 8 DB - Pediatrics Central DP - Unbound Medicine ER -