Sintusek P, Mutalib M, Thapar N. Gastroesophageal reflux disease in children: What’s new right now? World J Gastrointest Endosc 2023; 15(3): 84-102 [PMID: 37034973 DOI: 10.4253/wjge.v15.i3.84]
Corresponding Author of This Article
Nikhil Thapar, FRCP, MRCP, PhD, Professor, Department of Gastroenterology, Hepatology and Liver Transplant, Queensland Children’s Hospital, 501 Stanley Street, Brisbane QLD 4101, Queensland, Australia. nikhil.thapar@health.qld.gov.au
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Palittiya Sintusek, Thai Pediatric Gastroenterology, Hepatology and Immunology Research Unit (TPGHAI), Division of Gastroenterology, Department of Pediatrics, King Chulalongkorn Memorial Hospital and Thai Red Cross, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Bangkok, Thailand
Mohamed Mutalib, Department of Paediatric Gastroenterology, Pediatric and Gastroenterology Services, Evelina London Children’s Hospital, London SE1 7EH, United Kingdom
Nikhil Thapar, Department of Gastroenterology, Hepatology and Liver Transplant, Queensland Children’s Hospital, Brisbane, Queensland 4101, Australia
Nikhil Thapar, School of Medicine, University of Queensland, Brisbane, Queensland 4006, Australia
Nikhil Thapar, Woolworths Centre for Child Nutrition Research, Queensland University of Technology, Brisbane, Queensland 4101, Australia
Author contributions: Thapar N, Mutalib M, and Sintusek P contributed to conception of the study; Sintusek P drafted the manuscript; Sintusek P and Mutalib M wrote the manuscript; Thapar N made critical revisions related to the intellectual content of the manuscript; all authors read and approved the final version of the manuscript.
Supported bythe Research Grant Contract Allocated for Basic Research from the Chulalongkorn University, No. HEA663000047.
Conflict-of-interest statement: There are no conflicts of interest to report.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Nikhil Thapar, FRCP, MRCP, PhD, Professor, Department of Gastroenterology, Hepatology and Liver Transplant, Queensland Children’s Hospital, 501 Stanley Street, Brisbane QLD 4101, Queensland, Australia. nikhil.thapar@health.qld.gov.au
Received: October 27, 2022 Peer-review started: October 27, 2022 First decision: December 12, 2022 Revised: January 15, 2023 Accepted: February 8, 2023 Article in press: February 8, 2023 Published online: March 16, 2023
Abstract
Gastroesophageal reflux (GER) in children is very common and refers to the involuntary passage of gastric contents into the esophagus. This is often physiological and managed conservatively. In contrast, GER disease (GERD) is a less common pathologic process causing troublesome symptoms, which may need medical management. Apart from abnormal transient relaxations of the lower esophageal sphincter, other factors that play a role in the pathogenesis of GERD include defects in esophageal mucosal defense, impaired esophageal and gastric motility and clearance, as well as anatomical defects of the lower esophageal reflux barrier such as hiatal hernia. The clinical manifestations of GERD in young children are varied and nonspecific prompting the necessity for careful diagnostic evaluation. Management should be targeted to the underlying aetiopathogenesis and to limit complications of GERD. The following review focuses on up-to-date information regarding of the pathogenesis, diagnostic evaluation and management of GERD in children.
Core Tip: Gastroesophageal reflux disease (GERD) is a pathologic process requiring prompt assessment and treatment. The manifestations of GERD, especially in young children vary making it a challenge to diagnose. Combined esophageal pH-MII manometry has increased the diagnostic accuracy of GERD and helped explain its pathogenesis. Medication should be targeted to the underlying GERD pathogenesis, if known, and to minimize complications.
