Quitadamo P, Ummarino D, Staiano A
Department of Translational Medical Science Section of Pediatrics University "Federico II", Naples, Italy -
Minerva Pediatr. 2015 Apr;67(2):187-97. Epub 2015 Feb 3.
Gastroesophageal reflux (GER) is a normal physiologic process, consisting in the passage of gastric contents into the esophagus. It occurs several times per day in healthy infants, children, and adults. In contrast, gastroesophageal reflux disease (GERD) is present when the reflux of gastric contents causes troublesome symptoms and/or complications. Distinguishing GER from GERD may often be tricky. The diagnosis of GERD has to be inferred by performing tests showing excessive frequency or duration of reflux events, esophagitis, or a clear association of symptoms and signs with reflux events in the absence of alternative diagnoses. Only in older children and adolescents with typical reflux symtoms, a time-limited trial of acid suppressive treatment may be useful as diagnostic test. A proper differential diagnosis between GER, GERD and other possible conditions mimicking reflux is crucial in order to target the treatment, avoiding the overuse of acid suppressive medications which currently represents a major source of concern. In this review we went through the evidence-based possible strategies to manage both psychologic GER and GERD.
胃食管反流（GER）是一种正常的生理过程，表现为胃内容物进入食管。健康的婴儿、儿童和成人每天都会发生几次。相比之下，当胃内容物反流引起令人不适的症状和/或并发症时，就会出现胃食管反流病（GERD）。区分GER和GERD往往很棘手。GERD的诊断必须通过进行检查来推断，这些检查显示反流事件的频率或持续时间过长、食管炎，或者在没有其他诊断的情况下症状和体征与反流事件有明确关联。只有在患有典型反流症状的大龄儿童和青少年中，限时的抑酸治疗试验作为诊断测试可能有用。为了使治疗有的放矢，避免过度使用目前令人主要担忧的抑酸药物，对GER、GERD和其他可能模仿反流的情况进行恰当的鉴别诊断至关重要。在这篇综述中，我们梳理了基于证据的管理生理性GER和GERD的可能策略。
