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Abstract
Gastroesophageal reflux disease (GERD) and functional dyspepsia (FD) are common problems in the pediatric population, with up to 7% of school-age children and up to 8% of adolescents suffering from epigastric pain, heartburn, and regurgitation. Reflux is defined as the passage of stomach contents into the esophagus, while GERD refers to reflux symptoms that are associated with symptoms or complications—such as pain, asthma, aspiration pneumonia, or chronic cough. FD, as defined by the Rome III classification, is a persistent upper abdominal pain or discomfort, not related to bowel movements, and without any organic cause, that is present for at least two months prior to diagnosis. Endoscopic examination is typically negative in FD, whereas patients with GERD may have evidence of esophagitis or gastritis either grossly or microscopically. Up to 70% of children with dyspepsia exhibit delayed gastric emptying. Treatment of GERD and FD requires an integrative approach that may include pharmacologic therapy, treating concurrent constipation, botanicals, mind body techniques, improving sleep hygiene, increasing physical activity, and traditional Chinese medicine and acupuncture.
Highlights
IntroductionGastroesophageal reflux is the normal physiologic passage of gastric contents into the esophagus
Gastroesophageal reflux is the normal physiologic passage of gastric contents into the esophagus.When reflux and regurgitation cause symptoms and complications, it is defined as gastroesophageal reflux disease, or Gastroesophageal reflux disease (GERD)
When reflux and regurgitation cause symptoms and complications, it is defined as gastroesophageal reflux disease, or GERD
Summary
Gastroesophageal reflux is the normal physiologic passage of gastric contents into the esophagus. Treatment for GERD symptoms often includes an empiric trial of acid suppression. Pharmacologic therapies with acid suppression do not always effectively treat symptoms related to non-erosive reflux disease and reflux symptoms from non-acidic reflux. Integrative medicine is a healing oriented medicine that takes account of the whole patient, including all elements of lifestyle and family health. It emphasizes the powerful triad of patient-family-practitioner, is informed by evidence, and makes use of all appropriate therapies. In patients with GERD and FD, an integrative medicine treatment plan may include botanicals, mind-body techniques, sleep hygiene, increasing physical activity, and acupuncture, in addition to pharmacologic therapies. This paper will illustrate the integrative medicine approach with a case study and review the current scientific evidence on integrative medicine treatments for GERD and FD in children and adolescents
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