Gastro-oesophageal reflux in infancy

Gastro-oesophageal reflux (GOR) is a common phenomenon in infants, which ma y occur with or without accompanying symptoms. Although most infants presen ting with regurgitation have a normal physical examination, it is now recog nized that infants may also present with a wide variety of symptoms. Oesoph agitis is associated with increased oesophageal acid exposure. The determin ation of cause and effect is difficult, as there are many aspects of reflux disease where cause and effect relationships are cyclic. Reflux disease is present when there is an imbalance between a number of factors that can co ntribute to a decrease, as well as an increase, of GOR. Oesophageal pH moni toring with a semi-disposable monocrysant antimony pH catheter with three s ensors is very good at documenting oesophageal acidification and gastric bu ffering and, therefore, quantifies acid reflux frequency and duration. Howe ver, the interpretation of the data is complex as they are influenced by nu merous factors, such as position, activity (sleep, crying), feeding (freque ncy and composition) or medication. The duration of buffering of gastric ac idity during pH monitoring might, in the future, appear to be a relevant fa ctor in the interpretation of oesophageal pH data.