Diagnosis and management of gastro-oesophageal reflux

Abstract 

Gastro-oesophageal reflux (GOR) represents a considerable disease spectrum with a range of severity from an intermittent nuisance to life-threatening disease. Gastro-oesophageal reflux disease implies significant morbidity from the reflux. Children with GOR disease require investigation and consideration of the differential diagnosis. Children with respiratory disease are particularly prone to reflux and the presentation may be atypical. The different investigations and treatment regimes are discussed. The pH study is considered a gold standard but will miss alkaline reflux. The withdrawal of cisapride has resulted in the earlier use of acid-suppressing drugs, particularly proton pump inhibitors. Some children may benefit from a change in milk. Surgery is indicated in children in whom medical management has failed.

Keywords: reflux, oesophagitis, investigation, management

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• f1 E-mail: RM-Beattie@btinternet.com