Diagnosis and Treatment of Gastroesophageal Reflux Disease in Infants and Children
Gastroesophageal reflux is a frequent, nonspecific phenomenon in infants and children. The recommended approach for infants with uncomplicated regurgitation is the reassurance of the parents about the physiological nature of excessive regurgitation, and if necessary, completed with dietary recommend...
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Main Author: | |
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Format: | Article |
Language: | English |
Published: |
Wiley
2000-01-01
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Series: | Canadian Journal of Gastroenterology |
Online Access: | http://dx.doi.org/10.1155/2000/473678 |
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Summary: | Gastroesophageal reflux is a frequent,
nonspecific phenomenon in infants and children. The
recommended approach for infants with uncomplicated regurgitation
is the reassurance of the parents about the physiological nature
of excessive regurgitation, and if necessary, completed with
dietary recommendations for formula-fed infants. If, despite these
efforts, the symptoms persist, the administration of prokinetics
such as cisapride is recommended before investigations such as
esophageal pH monitoring are begun. Cisapride is the drug of
choice because it has the best efficacy and safety profile. In infants
and children presenting with symptoms that suggest esophagitis,
endoscopy of the upper gastrointestinal tract is recommended. If
there is severe esophagitis, acid suppression with H2 receptor antagonists
or proton pomp inhibitors is recommended, eventually
in combination with prokinetics. In life-threatening situations, or
in patients who are resistant to or dependent on acid suppressive
medication, a surgical procedure such as laparoscopic Nissen
should be considered. |
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ISSN: | 0835-7900 |