GERD symptoms found to be common among infants and children

  • Singendonk M & al.
  • J Pediatr Gastroenterol Nutr
  • 21 Jan 2019

  • curated by Miriam Davis, PhD
  • Clinical Essentials
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Takeaway

  • Symptoms of gastroesophageal reflux disease (GERD) are highly prevalent in children, affecting >25% of infants but disappearing by 12 months, and later affecting up to 38% of children >18 months, according to a systematic review.

Why this matters

  • This is the first systematic review of worldwide studies of prevalence and risk factors.

Study design

  • Systematic review of 25 epidemiological studies (n=487,969), of which 11 were of infants and 14 of children, after a search of PubMed, EMBASE, and Cochrane databases.
  • Funding: None.

Key results

  • Infants (0-18 months):
    • GERD symptoms were seen in >25% of infants on a daily basis.
    • GERD symptoms recede in frequency and completely disappear by 12 months.
  • Children (>18 months):
    • GERD symptoms vary widely (range, 0%-38% of children studied).
    • Overall, GERD symptoms seen in >10% on a weekly basis and in 25% on a monthly basis.
  • Risk factors:
    • Gender does not appear to affect prevalence in infants and children.
    • Higher BMI and use of alcohol and tobacco are linked to higher GERD prevalence.
    • Breastfeeding as a protective factor for reflux is found in some studies, but not others.
      • Current guidelines encourage breastfeeding in infants with physiological gastroesophageal reflux but suggest adding thickeners to pumped breast milk if infants have significant reflux.

Limitations

  • Significant heterogeneity across studies.