Gastro‐oesophageal reflux disease in infancy: a review based on international guidelines

Summary

• Gastro‐oesophageal reflux (GOR) in infancy is common, physiological and self‐limiting; it is distinguished from gastro‐oesophageal reflux disease (GORD) by the presence of organic complications and/or troublesome symptomatology.
• GORD is more common in infants with certain comorbidities, including history of prematurity, neurological impairment, repaired oesophageal atresia, repaired diaphragmatic hernia, and cystic fibrosis.
• The diagnosis of GORD in infants relies almost exclusively on clinical history and examination findings; the role of invasive testing and empirical trials of therapy remains unclear.
• The assessment of infants with vomiting and regurgitation should seek out red flags and not be attributed to GOR or GORD without considered evaluation.
• Investigations should be considered to exclude other pathology in infants referred with suspected GORD, and occasionally to confirm the diagnosis.
• Management of GORD should follow a step‐wise approach that uses non‐pharmacological options where possible and pharmacological interventions only where necessary.