Distinguishing gastroesophageal reflux from gastroesophageal reflux disease, emphasizing lifestyle changes as first-life therapy, and discussing treatment options with pediatric patients and their parents have all been endorsed by an AAP panel as appropriate options for dealing with the youngest patients with reflux.
In a paper published online this week, Jenifer R. Lightdale, MD, MPH, and David A. Gremse, MD, both of the AAP’s Section on Gastroenterology, Hepatology and Nutrition, support the guidelines developed by the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition, which distinguishes GERD from GER “as reflux associated with troublesome symptoms or complications.”
Jenifer R. Lightdale
Lightdale and Gremse also advocate medications and surgical interventions only for those children with GERD.
The paper also addressed FDA black box warnings on medications that promote gastric emptying and motility, and discussed the potential for overuse of proton pump inhibitors in children.
“Reflux of gastric contents into the esophagus occurs in over two-thirds of infants and is the topic of discussion with pediatricians at many routine infant visits,” Lightdale told Infectious Diseases in Children. “These guidelines are designed to be useful for appropriately managing the normal physiologic phenomena of GER, as well as gastroesophageal reflux disease (GERD), which can certainly cause complications.”
Disclosure: The researchers report no relevant financial disclosures.