Gastroesophageal Reflux in Children: Clinical Profile, Course and Outcome with Active Therapy in 126 Cases

Shepherd R.W., Wren J., Evans S., Lander M. and Ong T.H. (1987) Gastroesophageal Reflux in Children: Clinical Profile, Course and Outcome with Active Therapy in 126 Cases. Clinical Pediatrics, 26 2: 55-60. doi:10.1177/000992288702600201


Author Shepherd R.W.
Wren J.
Evans S.
Lander M.
Ong T.H.
Title Gastroesophageal Reflux in Children: Clinical Profile, Course and Outcome with Active Therapy in 126 Cases
Journal name Clinical Pediatrics   Check publisher's open access policy
ISSN 1938-2707
Publication date 1987
Sub-type Article (original research)
DOI 10.1177/000992288702600201
Volume 26
Issue 2
Start page 55
End page 60
Total pages 6
Subject 2735 Pediatrics, Perinatology, and Child Health
Abstract A clinical profile and the course and outcome with therapy of 126 infants and children with gastroesophageal reflux (GER), diagnosed at a median age of 2.5 months and followed for 1.5 to 3.5 years is presented. Features included repeated regurgitation or rumination (99%), signs suggesting esophageal pain (49%, excessive crying “colic,” sleep disturbance, Sutcliffe-Sandifer syndrome, respiratory symptoms 42%), failure to thrive (18%), and minor hematemesis (18%). Feeding problems and maternal distress were common, associated with child abuse in four cases. Therapy was initially conservative (posture, thickening of feeds, antacids, bethanechol), augmented by cimetidine in those with proven esophagitis (n = 34, 0.27%). Most (81%) were symptom-free by 18 months of age (55% by 10 months of age); 17 percent had fundoplication with good results; 2 percent have persisting symptoms beyond 2 years of age (1% failed surgery). No deaths were recorded. Surgery was performed for recurrent apneas/aspiration (6%), refractory esophagitis or stricture (5%), and failed medical management (7%). Esophagitis was a significant determinant to outcome, and the importance of selective early endoscopy is emphasized. GER is a cause of considerable morbidity in infants but, with active therapy, is self-limiting in the majority. Certain distinctive clinical signs indicate those patients who require detailed investigation and to whom more aggressive therapeutic efforts should be directed.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
Collection: Scopus Import
 
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Created: Tue, 26 Jul 2016, 03:09:56 EST by System User