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Gastro‐oesophageal reflux disease in infancy: a review based on international guidelines

Robert N Lopez and Daniel A Lemberg
Med J Aust 2020; 212 (1): . || doi: 10.5694/mja2.50447
Published online: 13 January 2020

Summary

  • Gastro‐oesophageal reflux (GOR) in infancy is common, physiological and self‐limiting; it is distinguished from gastro‐oesophageal reflux disease (GORD) by the presence of organic complications and/or troublesome symptomatology.
  • GORD is more common in infants with certain comorbidities, including history of prematurity, neurological impairment, repaired oesophageal atresia, repaired diaphragmatic hernia, and cystic fibrosis.
  • The diagnosis of GORD in infants relies almost exclusively on clinical history and examination findings; the role of invasive testing and empirical trials of therapy remains unclear.
  • The assessment of infants with vomiting and regurgitation should seek out red flags and not be attributed to GOR or GORD without considered evaluation.
  • Investigations should be considered to exclude other pathology in infants referred with suspected GORD, and occasionally to confirm the diagnosis.
  • Management of GORD should follow a step‐wise approach that uses non‐pharmacological options where possible and pharmacological interventions only where necessary.
  • Robert N Lopez1
  • Daniel A Lemberg2

  • 1 Queensland Children's Hospital, Brisbane, QLD
  • 2 Sydney Children's Hospital, Sydney, NSW


Competing interests:

No relevant disclosures.

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