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ESOPHAGUS AND STOMACH
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GASTROESOPHAGEAL REFLUX DISEASE
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Gastroesophageal reflux (GER) is a physiologic process of stomach contents regurgitating into the esophagus. Gastroesophageal reflux disease (GERD) occurs when GER is accompanied by disturbing symptoms or complications such as esophagitis, respiratory disease, failure to thrive, and/or neurobehavioral manifestations.
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In infants, most GER is physiologic and benign
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Functional GER occurs in more than half of all infants
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Most common esophageal disorder
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CLINICAL MANIFESTATIONS
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Functional/Simple GER: Silent oral regurgitation, effortless spitting, or forceful vomiting; symptoms peak at 1–4 months and resolve by 12–18 months of age; usually benign
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Complicated GER (GERD): Significant complications develop in about 10% of untreated children
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✓ Esophagitis: Crying, irritability, food aversion, heartburn, epigastric or chest pain, odynophagia, hematemesis, anemia, and/or guaiac-positive stools
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✓ Respiratory: Laryngospasm, bronchospasm, microaspiration pneumonia
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✓ Failure to thrive
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✓ Neurobehavioral manifestations: Sandifer syndrome (opisthotonic posturing, head tilting, seizure-like activity); arching; excessive irritability
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