Gastro-oesophageal reflux

Abstract Gastro-oesophageal reflux (GOR) is a self-limiting cause of posseting in young infants. Gastro-oesophageal disease refers to potentially life-threatening symptomatology secondary to severe, persistent GOR. Failure to thrive, oesophagitis, and oesophageal stricture may develop, and acute life-threatening events may occur. Neurologically impaired children are a high-risk group in whom aspiration and recurrent chest infections may necessitate repeated hospital admissions. When empirical medical treatment with H2 blockers or proton pump inhibitors is ineffective, investigation with pH/impedance studies, contrast studies, and endoscopy may be undertaken. Anti-reflux surgery includes fundoplication and oesophago-gastric dissociation, whereas feeding adjuncts, including gastrostomy and jejunostomy, are frequently required in the management of the neurologically impaired. Recurrent symptoms and tube mishaps are a fact of life.