Pathophysiology of GER

Nurko, Samuel

doi:10.1007/978-3-030-99067-1_2

Cited by 2 publications

(2 citation statements)

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“…As infants grow older, anatomical changes include increased accommodation of larger gastric volumes and maturation of the lower esophageal sphincter resulting in decreased reflux into the esophagus 10,12 . Gastroesophageal reflux disease pathophysiology is similarly multifactorial; however, it is related more to the function, anatomy, clearance, and degree of mucosal damage in the esophagus 13 . Factors that cause gastric distension including delayed gastric emptying, acid secretion, or mucosal injury can lead to greater pressure in the stomach over the lower esophageal sphincter causing regurgitation into the esophagus and mouth.…”

Section: Learning Objectivesmentioning

confidence: 99%

“…10,12 Gastroesophageal reflux disease pathophysiology is similarly multifactorial; however, it is related more to the function, anatomy, clearance, and degree of mucosal damage in the esophagus. 13 Factors that cause gastric distension including delayed gastric emptying, acid secretion, or mucosal injury can lead to greater pressure in the stomach over the lower esophageal sphincter causing regurgitation into the esophagus and mouth. Gastroesophageal reflux disease can result in esophageal symptoms (vomiting, abdominal/chest discomfort) and extraesophageal conditions (poor weight gain, cough, wheezing, dental caries/erosions, recurrent otitis media).…”

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confidence: 99%

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Diagnosis and Management of Pediatric Gastroesophageal Reflux in the Emergency Department

2023

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Gastroesophageal reflux (GER) is a common physiologic occurrence in infants, children, and adolescents and can develop into a pathological process (GERD) with associated complications. Gastroesophageal reflux is reported in approximately 30% of healthy infants, with a peak age of 3 to 4 months and is a common concern from families presenting to the emergency department. Evaluation and diagnosis of GER/GERD is primarily clinical and requires a detailed history, a complete physical examination, and exclusion of more severe extraesophageal pathologies. A high index of suspicion for GERD should be considered in patients with recurrent respiratory symptoms, difficulty with weight gain, and children with medically complex conditions who would be at higher risk for these complications. This review will briefly discuss diagnostic studies for the evaluation of GER/GERD; however, these are not helpful in the acute care setting and should be reserved for evaluation by a subspecialist. Management of GER/GERD includes nonmedication management with reflux precautions and dietary/lifestyle modifications; medication management with proton-pump inhibitors, H2 blockers, antacids, or prokinetics, as well as surgical management for refractory or high-risk cases.

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Section: Learning Objectivesmentioning

confidence: 99%

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confidence: 99%