Gastric reflux: the pediatrician’s point of view

Abstract

Gastroesophageal reflux (GER)in infants is the most common causes for physician consultation worldwide. Moreover, GER disease (GERD) also affects children. In addition, laryngopharyngeal reflux (LPR) may also affect children. As a result, the pediatrician has to often manage these diseases in daily practice. An educational program concerning updating knowledge about this issue was performed in a panel of 246 Italian pediatricians. The prescriptive attitude was assessed before and after the educational course. History, mainly regarding treatments, Infant Gastroesophageal Reflux Questionnaire (I-GERQ),GERD-Q, and reflux symptom index (RSI) were administered. The group of infants included 1,800 infants.The group of children included 1,706 subjects. There was a shift for monot herapy in infants’ management from 86.3% to 96%. In particular, the quote of alginate monotherapy increased from 79% to 94%. On the contrary, proton pump inhibitor (PPI) monotherapy decreased from 17.5% to 5%. Polytherapy substantially did not change. There was a shift for monotherapy from 74% to 88.4% in children’s management. In particular, the quote of alginate monotherapy increased from 34% to 65.3%.On the contrary, PPI monotherapy decreased from 30% to 10.7%. Polytherapy substantially did not change.In conclusion, the current experience demonstrated that GERD is a widespread medical problem in infants andchildren, and LPR significantly affects children. Updating the knowledge on gastric reflux significantly changed the prescriptive attitude of pediatricians. Alginates were the most common substance used in managing infants and children with gastric reflux. Therefore, PPI is used mostly combined with alginates.