Diagnosis and treatment of gastroesophageal reflux disease in infants and children

Table 1 Symptoms of GER (-disease)

Usual manifestations	Symptoms possibly related to complications of GER*
Specific manifestations
Regurgitation	Symptoms related to anaemia (iron deficiency anaemia)
Nausea	Haematemesis and melaena
Vomiting	Dysphagia (as a symptom of oesophagitis or due to stricture formation)
	Weight loss and/or failure to thrive
	Epigastric or retrosternal pain
	“Non-cardiac angina-like” chest pain
	Pyrosis or heartburn, pharyngeal burning
	Belching, postprandial fullness
	Irritable oesophagus
	General irritability (infants)
Unusual presentations
GER related to chronic respiratory disease (bronchitis, asthma, laryngitis, pharyngitis, etc.)
Sandifer Sutcliffe syndrome
Rumination
Apnea, apparent life threatening event and sudden infant death syndrome
Associated to congenital and/or central nervous system abnormalities
Intracranial tumors, cerebral palsy, psychomotory retardation

A number of these symptoms may also be caused by other mechanisms.