ROLE OF GASTROESOPHAGEAL REFLUX IN INFANT IRRITABILITY

Gastro-oesophageal reflux (GOR) disease may cause excessive crying in infants. The role of GOR was evaluated in infant irritability and an a ttempt was made to define clinical predictors of pathological reflux. Seventy consecutively admitted infants with irritability and presumpti ve GOR were retrospectively reviewed. All had undergone prolonged oeso phageal pH monitoring. Pathological GOR was defined as a fractional re flux time of greater than or equal to 10% and was significantly less c ommon in infants under 3 months (one of 24; 4 . 2%) than in older infa nts (10 of 46; 21 . 7%). All infants with pathological GOR presented w ith frequent vomiting, and 'silent' pathological reflux did not occur. Poor weight gain, feeding refusal, backarching, and sleep disturbance were not significantly associated with pathological GOR. The results suggest that pathological GOR is an unlikely cause of infant irritabil ity under the age of 3 months.