Abstract

Gastroesophageal reflux (GER) is a retrograde flow of gastric contents into the esophagus with or without regurgitation and vomiting. This physiologic phenomenon is most frequently after meals and could happen several times a day for a short period (no more than 3 minutes). It covers 1-5% of the day in healthy infants, children and adolescents. GER accompanied by bothersome symptoms is considered gastroesophageal reflux disease (GERD). Given the lack of specific symptoms, GERD diagnosis must be made on the basis of clinical symptoms and standardized questionnaires together with esophageal 24 hour multichannel intraluminal impedance monitoring, which provides more precise information than esophageal pH monitoring because it allows identification of both acidic and nonacidic reflux and determines the relationship between symptoms and episodes of reflux. Close cooperation between general practitioners, ENT specialists, paediatricians and pediatric gastroenterologists enables refinement of diagnosis and helps correct therapeutic approach in the treatment of GERD in children.

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