GASTROESOPHAGEAL REFLUX DISEASE (GERD) IN INFANTS: FROM DEFINITIONS TO TREATMENT: A SYSTEMATIC REVIEW

Abstract

Objective: The objective of this literature review was to compile the current knowledge on the definition, epidemiology, pathophysiology, risk factors, clinical manifestations, complications, and treatments associated with gastroesophageal reflux disease (GERD) in infants and children. Methodology: Searches were carried out through searches in the PubMed Central (PMC) and Virtual Health Library (VHL) databases. Three main descriptors were used combined with the Boolean term "AND": Gastroesophageal Reflux, Pediatrics and Treatment. The search strategy used in the PMC database was: Gastroesophageal Reflux AND Pediatrics AND Treatment, while in the VHL it was: Gastroesophageal Reflux AND Pediatrics. After this initial search, 78 articles were found, which were submitted to the selection criteria. After screening, 9 articles were selected to compose this review. Results: The data revealed that GERD is a prevalent condition in infants, especially in preterm infants and children with neurological or congenital conditions. Its manifestations vary, and regurgitation, vomiting, refusal to feed and irritability are the most frequent symptoms in the first years of life. Complications include esophagitis, breathing difficulties, growth retardation, and, in severe cases, apnea and aspiration pneumonia. Diagnosis is often clinical, with additional tools used only in cases of diagnostic doubt or suspected complications. Management includes non-pharmacological and pharmacological measures and, in more severe cases, surgical treatment. Conclusion: It is concluded that the characterization of GERD in infants and children is essential to ensure effective symptomatic control and prevent long-term complications. Treatment should be individualized, based on the severity of symptoms and associated conditions, including non-pharmacological, pharmacological, and, when necessary, surgical approaches.