GASTROESOPHAGEAL REFLUX IN CHILDREN

Disordered motility of the gastrointestinal tract in children is usual ly manifest as gastro-oesophageal reflux disease. Reflux is common in infants but usually resolves spontaneously with time. If severe enough to merit investigation, 24-hour ambulant oesophageal pH monitoring is the most widely used investigation, though lit does have disadvantage s. Upper gastrointestinal endoscopy and biopsy may be required to diag nose oesophagitis, Treatment follows a step-wise approach, progressing from positioning and feed-thickening in infants, through to pharmacol ogical management with prokinetic agents and/or acid-suppression, and surgery for a very small proportion of children whose symptoms do not respond to optimal medical therapy. (C) 1998 Lippincott-Raven Publishe rs.