Gastroesophageal Reflux
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 MDM, ed. 5-Minute Pediatric Consult. Wolters Kluwer; 2019. https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617413/all/Gastroesophageal_Reflux. Accessed November 4, 2024.
Gastroesophageal Reflux. (2019). In Cabana, M. D. (Ed.), 5-Minute Pediatric Consult (8th ed.). Wolters Kluwer. https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617413/all/Gastroesophageal_Reflux
Gastroesophageal Reflux [Internet]. In: Cabana MDM, editors. 5-Minute Pediatric Consult. Wolters Kluwer; 2019. [cited 2024 November 04]. 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
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