Gatro-oesophageal reflux disease in pediatrics
Management and differential diagnosis
Patients with mild, uncomplicated reflux can be diagnosed clinically and treated without further
investigations. However when the history is atypical or when complications are present, further
investigations is indicated.
The best diagnostic test is oesophageal PH monitoring. Contrast studies of the upper
gastrointestinal tract maybe required to exclude underlying anatomical abnormalities in the
oesophagus, stomach, duodenum and malrotation.
Endoscopy and oesophageal biopsy are performed in some cases if oesophagitis is suspected.
It is worthwhile treating all infants with symptomatic reflux, repeated regurgitation that is smelly
and unpopular to the family.
GENERAL MANAGEMENT
Diagnosis and treatment of the underlying cause of disease
Timely detection and correction of fluids and electrolytes imbalance
Alleviation of symptoms and maintenance of optimal nutritional status.
DIERERY AND LIFESTYLE MODIFICATIONS
Small volume and frequent meals, with low content in fats and non-digestible fibers
Patients are advised to avoid carbonated beverages and lying down 1-2 hours after a meal
Enteral nutrition via nasojejunal tube or jejunostomy may be required for patients with
severely impaired nutritional status.
Addition of inert thickening agents to feeds,,e.g. (Nestargel and carobel)-prethicked anti-
reflux formulas.
Positioning in a 30* head up prone position after feeds
Management and differential diagnosis
Patients with mild, uncomplicated reflux can be diagnosed clinically and treated without further
investigations. However when the history is atypical or when complications are present, further
investigations is indicated.
The best diagnostic test is oesophageal PH monitoring. Contrast studies of the upper
gastrointestinal tract maybe required to exclude underlying anatomical abnormalities in the
oesophagus, stomach, duodenum and malrotation.
Endoscopy and oesophageal biopsy are performed in some cases if oesophagitis is suspected.
It is worthwhile treating all infants with symptomatic reflux, repeated regurgitation that is smelly
and unpopular to the family.
GENERAL MANAGEMENT
Diagnosis and treatment of the underlying cause of disease
Timely detection and correction of fluids and electrolytes imbalance
Alleviation of symptoms and maintenance of optimal nutritional status.
DIERERY AND LIFESTYLE MODIFICATIONS
Small volume and frequent meals, with low content in fats and non-digestible fibers
Patients are advised to avoid carbonated beverages and lying down 1-2 hours after a meal
Enteral nutrition via nasojejunal tube or jejunostomy may be required for patients with
severely impaired nutritional status.
Addition of inert thickening agents to feeds,,e.g. (Nestargel and carobel)-prethicked anti-
reflux formulas.
Positioning in a 30* head up prone position after feeds
