Do not prescribe drugs (Histamine receptor antagonists, proton pump inhibitors and prokinetics) in physiological gastroesophageal reflux (GER), which does not impair growth and is not associated with suspected signs or symptoms of GER disease . Inform and support parents.

Do not prescribe drugs (Histamine receptor antagonists, proton pump inhibitors and prokinetics) in physiological gastroesophageal reflux (GER), which does not impair growth and is not associated with suspected signs or symptoms of GER disease . Inform and support parents.

Type of practice

Drugs

Age

Pediatric

Topic Area

Paediatrics

Physiological GER is a very frequent cause of regurgitation or vomiting in healthy children in the first year of life, resolves with growth and there is no significant evidence that it causes injury, even in the long term. In newborns and infants, the appearance of crying fits, restlessness, arching of the trunk, sometimes associated with even abundant regurgitation, can be physiological manifestations of an evolutionary phase. It is necessary to be able to differentiate the physiological GER from that associated with symptoms that deserve a diagnostic study. Parents need to be adequately informed about the significance of signs and symptoms and supported in the management of these physiological manifestations. Pump inhibitors and Histamine receptor antagonists are not effective in resolving GER and their use should be reserved exclusively for GER disease (GERD) which is very rare in pediatric age and mostly related to predisposing conditions. In the GER there are no indications for the use of prokinetic drugs. The use of drugs for GERD is not indicated as an empirical treatment for diagnostic purposes in newborns and infants.

Sources

1. Rosen R, Vandenplas Y, Singendonk M et al. Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology Hepatology and Nutrition (ESPGHAN). J Pediatr Gastroenterol Nutr 2018;66:516-54.
2. Barfield E, Parker M. Management of Pediatric Gastroesophageal Reflux Disease. JAMA Pediatrics 2019;173:485-6.
3. Heitlinger L. Guidelines for Management of Pediatric Gastroesophageal Reflux. JAMA Otolaryngology-Head & Neck Surgery 2018;144:755-6.

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Attention. Please note that these items are provided only for information and are not intended as a substitute for consultation with a clinician. Patients with any specific questions about the items on this list or their individual situation should consult their clinician.