ABSTRACT
Gastroesophageal reflux disease (GERD) occurs when the retrograde passage of gastric contents causes recurrent troublesome symptoms or complications. The incidence of esophagitis in patients with GERD ranges between 50% and 80%, based on studies in adults. GERD and its complications are more commonly seen in children with one or more of the following risk factors: neurologic impairment, obesity, prematurity, chronic lung disease, congenital malformations such as esophageal atresia, hiatal hernia, or a first-degree relative with severe GERD. Children and adolescents with reflux esophagitis typically present with recurrent pain in the upper abdomen or chest and frequent heartburn. The clinical presentation of GERD in infants may include irritability, posturing, feeding refusal, dysphagia, poor growth, and in rare cases, hematemesis. Diagnosis is usually clinical, but endoscopic examination is helpful to determine severity and to establish etiology of symptoms. Laboratory tests are of little utility in the diagnosis of GERD.
