Respiratory Manifestations of Gastroesophageal Reflux Disease in Pediatric Patients

Respiratory manifestations of gastroesophageal reflux disease (GERD) are being recognized with increasing frequency. We present the evaluation and management of four infants and children with unusual respiratory symptoms attributed to GERD. The advantages and disadvantages of diagnostic studies of GERD are discussed, and an evaluation and treatment protocol is presented. Treatment must be tailored to the nature and severity of the patient's presenting symptoms and includes conservative, pharmacologic, and/or surgical management.

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MODERN METHODS FOR DIAGNOSING PATHOLOGY OF THE CARDIO-ESOPHAGEAL TRANSITION IN CHILDREN

Российский педиатрический журнал ◽

10.18821/1560-9561-2020-23-1-42-47 ◽

2020 ◽

Vol 23 (1) ◽

pp. 42-47

Author(s):

Igor V. Poddubny ◽

Valentin V. Sytkov ◽

Ivan E. Smirnov ◽

Yuliya D. Vorobyeva ◽

Kirill N. Tolstov

Keyword(s):

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

Literature Search ◽

Pediatric Patients ◽

Web Of Science ◽

Diagnostic Methods ◽

Advantages And Disadvantages ◽

Modern Methods ◽

Anatomical Localization

The pathology of the esophagus is diverse, therefore, disorders of the structural and functional state of the esophagus require different approaches both in the diagnosis of its pathology and in treatment. The review presents data on innovative diagnostic methods for the pathology of the cardio-esophageal transition in pediatric patients. The methods used were literature search in the databases PubMed, Medlit, RSCI, Scopus, Web of Science, EMBASE. Modern ideas about the neurophysiology of the gastroesophageal transition, the mechanisms of its antireflux function, and the pathogenesis of various pathologies of this anatomical localization, mainly gastroesophageal reflux disease (GERD), are described in both infants and school children. The features of the clinical picture of GERD depending on the age of the patient and the nature of the reflux agent are presented. The phenotypes of reflux disease are determined. The characteristics and modifications of existing original methods for studying the cardio-esophageal transition (both their advantages and disadvantages) are described in detail. The approaches to the possible optimization of management of this group of patients are proposed.

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Clinical Management of Infants and Children with Gastroesophageal Reflux Disease

The Journal of Pediatric Pharmacology and Therapeutics ◽

10.5863/1551-6776-9.4.243 ◽

2004 ◽

Vol 9 (4) ◽

pp. 243-253

Author(s):

John Whitworth ◽

Michael L. Christensen

Keyword(s):

Weight Gain ◽

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

Normal Weight ◽

Lifestyle Changes ◽

Infants And Children ◽

Pharmacologic Therapy ◽

Presenting Symptoms ◽

Normal Weight Gain

Gastroesophageal reflux refers to the passage of gastric contents including food, acid, and digestive enzymes up into the esophagus. Reflux is most commonly recognized in infants when it is associated with regurgitation, known as “spitting up,” and it is usually a self-limited, benign process that has little or no effect on normal weight gain or development. Adults and adolescents may also have reflux, which is usually either asymptomatic or recognized as dyspepsia or “heartburn.” Gastroesophageal reflux disease (GERD) is defined as symptoms or complications that result from reflux. Most evidence suggests the mechanism of reflux is due to transient relaxations of the lower esophageal sphincter at inappropriate times. The diagnosis of suspected GERD in infants and children depends on the age and the presenting symptoms. A thorough history, physical examination, and growth charts are sufficient for the evaluation and diagnosis of GERD in most infants with recurrent vomiting or children with regurgitation and heartburn. Additional evaluation may include an upper gastrointestinal series, esophageal pH monitoring, or endoscopy. The goals of GERD management are eliminating symptoms, healing esophagitis, preventing complications, promoting normal weight gain and growth, and maintaining remission. Therapeutic options include lifestyle changes, pharmacologic therapy, and anti-reflux surgery. Currently available pharmacologic agents for the treatment of GERD include antacids, mucosal protectants, prokinetic agents, and acid suppressants.

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C1/170 – Effects of pectin liquid on respiratory symptoms in neurologically impaired children with gastroesophageal reflux disease

Paediatric Respiratory Reviews ◽

10.1016/j.prrv.2006.04.071 ◽

2006 ◽

Vol 7 ◽

pp. S295

Author(s):

R. Miyazawa ◽

H. Kaneko ◽

T. Tomomasa ◽

N. Shimizu ◽

A. Morikawa

Keyword(s):

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

Respiratory Symptoms ◽

Neurologically Impaired ◽

Neurologically Impaired Children ◽

Impaired Children

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Surgical Management of Pediatric Gastroesophageal Reflux Disease

Gastroenterology Research and Practice ◽

10.1155/2013/863527 ◽

2013 ◽

Vol 2013 ◽

pp. 1-8 ◽

Cited By ~ 5

Author(s):

Hope T. Jackson ◽

Timothy D. Kane

Keyword(s):

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Surgical Management ◽

Reflux Disease ◽

Clinical Presentation ◽

Pediatric Population ◽

Treatment Options ◽

Failure To Thrive ◽

Solid Diet ◽

Esophageal Sphincter

Gastroesophageal reflux (GER) is common in the pediatric population. Most cases represent physiologic GER and as the lower esophageal sphincter (LES) matures and a solid diet is introduced, many of these patients (>65%) experience spontaneous resolution of symptoms by two years of age. Those who continue to have symptoms and develop complications such as failure to thrive, secondary respiratory disease, and others are classified as having gastroesophageal reflux disease (GERD). Goals of GERD treatment include the resolution of symptoms and prevention of complications. Treatment options to achieve these goals include dietary or behavioral modifications, pharmacologic intervention, and surgical therapy. This paper will review the clinical presentation of GERD and discuss options for surgical management and outcomes in these patients.

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