Rybak Anna, Pesce Marcella, Thapar Nikhil, Borrelli Osvaldo
Department of Gastroenterology, Division of Neurogastroenterology and Motility, Great Ormond Street Hospital, London WC1N 3JH, UK.
Department of Clinical Medicine and Surgery, University of Naples Federico II, 80138 Napoli, Italy.
Int J Mol Sci. 2017 Aug 1;18(8):1671. doi: 10.3390/ijms18081671.
Gastro-esophageal reflux (GER) is common in infants and children and has a varied clinical presentation: from infants with innocent regurgitation to infants and children with severe esophageal and extra-esophageal complications that define pathological gastro-esophageal reflux disease (GERD). Although the pathophysiology is similar to that of adults, symptoms of GERD in infants and children are often distinct from classic ones such as heartburn. The passage of gastric contents into the esophagus is a normal phenomenon occurring many times a day both in adults and children, but, in infants, several factors contribute to exacerbate this phenomenon, including a liquid milk-based diet, recumbent position and both structural and functional immaturity of the gastro-esophageal junction. This article focuses on the presentation, diagnosis and treatment of GERD that occurs in infants and children, based on available and current guidelines.
胃食管反流(GER)在婴幼儿和儿童中很常见,临床表现多样:从单纯反流的婴儿到患有严重食管和食管外并发症的婴幼儿,后者被定义为病理性胃食管反流病(GERD)。尽管其病理生理与成人相似,但婴幼儿GERD的症状往往与烧心等典型症状不同。胃内容物进入食管在成人和儿童中都是一天中多次发生的正常现象,但在婴儿中,有几个因素会加剧这种现象,包括以液体奶为主的饮食、卧位以及胃食管交界处的结构和功能不成熟。本文根据现有和当前指南,重点介绍婴幼儿GERD的表现、诊断和治疗。