Gastroesophageal reflux disease in children

Gastoesophageal reflux disease in children is a chronic relapsing disease that is characterized by cases of abnormal casting of stomach contents into the esophagus, regardless of whether morphological changes occur in the esophagus or not. In most patients, as a result of frequent casting, the mucosa of the esophagus becomes inflamed, reflux esophagitis develops.

ICD-10 code

K21.0. Gastroesophageal reflux disease.

Epidemiology of gastroesophageal reflux disease in children

The true incidence of gastroesophageal reflux disease in children is unknown. The frequency of diagnosis of reflux-esophagitis in children with diseases of the digestive system is, according to different authors, 8.7-17%.

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Symptoms of gastroesophageal reflux disease in children

In the structure of clinical symptoms of gastroesophageal reflux disease in children, esophageal and extra-oesophageal symptoms are distinguished.

Esophageal symptoms include heartburn, regurgitation, a symptom of a "wet spot on the pillow," belching (air, sour, bitter), periodic chest pain, pain or discomfort when passing through the esophagus (lonely phlegm), dysphagia. The degree of severity of these symptoms in children is due mainly to the state of the lower esophageal sphincter motility, and not to the morphological state of the mucosa of the esophagus.

Symptoms of gastroesophageal reflux disease in children

Classification of gastroesophageal reflux disease

A single classification of gastroesophageal reflux disease in children has not been developed. Below is a working classification of Privorotsky V.F. And Luppova N.E. (2006).

1. The degree of severity of gastroesophageal reflux (according to the results of endoscopic examination):
   • without esophagitis;
   • with esophagitis (I-IV degree). The degree of motor disorders in the zone of the esophageal-gastric transition (A, B, C).
2. The degree of severity of gastroesophageal reflux (according to the results of X-ray study):
   • gastroesophageal reflux I-IV degree, sliding hernia of the esophageal opening of the diaphragm.
3. The severity of clinical symptoms:
   • light;
   • average;
   • heavy.
4. Infection with H. pylori:
   • HP (+);
   • HP (-).
5. Extraepsophageal signs of gastroesophageal reflux disease:
   • bronchopulmonary;
   • otorhinolaryngological;
   • cardiological;
   • dental.
6. Complications of gastroesophageal reflux disease:
   • Barrett's esophagus;
   • stricture of the esophagus;
   • posthemorrhagic anemia.

Causes and pathogenesis of gastroesophageal reflux disease in children

[8], [9], [10], [11], [12], [13]

Diagnosis of gastroesophageal reflux disease

After a survey of the thoracic and abdominal cavities, the esophagus and stomach with barium in the straight and lateral projections, in the Trendelenburg position with a slight compression of the abdominal cavity, are examined standing. Assess the patency and diameter of the esophagus, the relief of the mucous membrane, the nature of peristalsis. Gastoesophageal reflux disease is characterized by a reverse cast of contrast from the stomach into the esophagus.

Diagnosis of gastroesophageal reflux disease in children

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Treatment of gastroesophageal reflux disease in children

Treatment for gastroesophageal reflux disease consists of 3 components:

1. a complex of non-medicamentous effects, mainly the normalization of the way of life, the regime of the day and nutrition;
2. conservative therapy;
3. surgical correction.

How is gastroesophageal reflux disease treated in children?