In order to effectively manage and treat reflux-related symptoms, it is important for pediatricians to distinguish patients with physiologic gastroesophageal reflux (GER) from those with gastroesophageal reflux disease (GERD)
. GER is defined as the normal passage of gastric contents into the esophagus, while GERD includes the troublesome symptoms or complications associated with GER.
In the new American Academy of Pediatrics (AAP) clinical report, “Gastroesophageal Reflux: Management Guidance for the Pediatrician
,” in the May 2013 Pediatrics (published online April 29), pediatricians are encouraged to follow the recommendations developed by the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition when diagnosing and treating GER and GERD.
Lifestyle changes, which can include feeding and/or position changes, are recommended as first-line therapy for both conditions, while medications are explicitly indicated only for patients with GERD. The statement also provides algorithms for management of vomiting in infancy
, and treatment options for older children or adolescents with heartburn. Surgery can be risky and is usually reserved for children who are at risk for life-threatening complications. Although the number of reports of GERD in patients of all ages is increasing, it is still much less common than GER, which affects most healthy newborns.
The AAP believes it is important for all pediatric health care providers to be able to properly identify and treat children with reflux symptoms, and to distinguish GER from more worrisome disorders so as to avoid unnecessary costs and treatments.
Healthy Children Radio: Baby Spitting Up? It May Not Be Reflux (Audio)
All babies spit up
. How do you know if your baby's symptoms are part of a larger problem?
Pediatric gastroenterologist David Gremse, MD, the lead author of the AAP clinical report on gastroesophageal reflux
, comes on the Healthy Children Radio show on RadioMD to help parents determine if their baby's spitting up is something to worry about or just normal digestive functioning. Segment 1: Baby Spitting Up? It May Not Be Reflux