Gastroesophageal reflux in infants and children: a useful classification and reliable physiologic technique for its demonstration.

A radiologic method for the demonstration of gastroesophageal reflux in children is described, and, while recognizing limitations and pitfalls of any classification, a clinically useful system of grading of reflux is presented. The system is based primarily on the extent of retrograde flow of barium, ranging from reflux into the distal esophagus only (grade 1) to reflux with aspiration into the trachea or lungs (grade 5). The availability of a standardized radiologic technique for the demonstration of gastroesophageal reflux and a system for grading its severity may be useful in understanding the true incidence and significance of this disorder.