Gastroesophageal reflux (GERD) naturally occurs in healthy patients less than 3three times per daydaily when contents enter the esophagus with or without regurgitation. However, gastroesophageal reglux disease (GERD) is reflux with the presence of bothersome or harmful symptoms and complications1. In pediatric patients, symptoms include regurgitation or spitting up, poor weight gain or weight loss, irritability, dysphasia, stridor, cough, hoarseness, hematemesis, and chest pain indicating heartburn. If left untreated, GERD can lead to more serious complications, such as erosive esophagitis and Barrett’s esophagus, which has been linked to esophageal carcinoma1. A 2009 study by Nelson, et al., assessed the incidence of GERD in pediatric patients and showed that
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This recommendation is also supported in the American College of Gastroenterology guidelines for the management of GERD3. Both H2RAs and PPIs work to suppress gastric acid via inhibition of receptors and influx pumps that function to increase the gastric acid production. Although the utility of pH for the diagnosis and management of extraesophageal complications is not well established, gastric pH may be useful in monitoring and evaluating the efficacy of anti-secretory agents. Therefore, gastric pH may be utilized as an objective, surrogate marker of symptom relief. While both classes of medications are generally well tolerated for short term therapy, they have been associated with serious side effects including CAP, CDAD, impaired bone development, SBBO, as well as electrolyte, vitamin, and mineral deficiencies with long term thearpy4,5,6,7,8
This recommendation is also supported in the American College of Gastroenterology guidelines for the management of GERD3. Both H2RAs and PPIs work to suppress gastric acid via inhibition of receptors and influx pumps that function to increase the gastric acid production. Although the utility of pH for the diagnosis and management of extraesophageal complications is not well established, gastric pH may be useful in monitoring and evaluating the efficacy of anti-secretory agents. Therefore, gastric pH may be utilized as an objective, surrogate marker of symptom relief. While both classes of medications are generally well tolerated for short term therapy, they have been associated with serious side effects including CAP, CDAD, impaired bone development, SBBO, as well as electrolyte, vitamin, and mineral deficiencies with long term thearpy4,5,6,7,8