Gastroesophageal reflux in children.

Gastroesophageal reflux is so common in infancy that the phenomenon is usually considered to be physiologic. However, reflux in infants has also been related to severe morbidity and even death. The art of selecting the optimal approach to treating reflux in children is to avoid over-investigations and over-treatment as well as the other extreme of neglecting the problem. Therefore investigations should be limited to a minimum and the treatment chosen should be effective but at the same time as free of side effects as possible. Since the basic pathophysiologic mechanism of reflux disease in children is a motility problem, prokinetic agents are indicated for the treatment of this condition. The very low incidence of side effects with these agents is also a relevant advantage to their use in the treatment of pediatric reflux disease.