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Extra-esophageal Manifestations of Pediatric Gastroesophageal Reflux Disease: Updated Review

  • Pediatric Gastroenterology (SA Saeed and K Sandberg, Section Editors)
  • Published:
Current Treatment Options in Pediatrics Aims and scope Submit manuscript

A Correction to this article was published on 20 January 2022

This article has been updated

Abstract

Purpose of Review

Gastroesophageal reflux disease (GERD) is a common pediatric condition that can present with a wide array of esophageal and extra-esophageal manifestations. In addition to examining the association between GERD and extra-esophageal manifestations, this review will explore the various diagnostic and treatment strategies for patients with the disorder.

Recent Findings

Combined pH and multichannel intraluminal impedance (pH-MII), in contrast to isolated pH probe monitoring, can detect both full-column reflux events and non-acid reflux events, allowing greater insight into the potential pathophysiology of extra-esophageal manifestations. Studies have thus far failed to show a significant benefit from treating presumed extra-esophageal manifestations with either proton-pump inhibitors (PPI) or H2-receptor antagonists (H2-RA); similarly, researchers have yet to consistently prove any benefit from anti-reflux surgery on extra-esophageal manifestations.

Summary

The association between GERD and extra-esophageal manifestations remains poorly defined, due in part to a paucity in mechanistic studies investigating a causal link between them. From a diagnostic standpoint, while combined pH-MII has enabled greater insight into the pathophysiology of extra-esophageal manifestations, studies investigating the utility of less-invasive diagnostic modalities for extra-esophageal manifestations, such as measurement of salivary pepsin, remain inconclusive. On the other hand, despite the existence of several pharmacologic, non-pharmacologic, and surgical options, there remains a pressing need for large-scale trials investigating their efficacy in patients with extra-esophageal manifestations.

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References and Recommended Reading

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  1. Department of Pediatric Gastroenterology, Nationwide Children’s Hospital, 700 Children’s Drive, OH, 43205, Columbus, USA

    Zeyad M. Abdulkader MD, Frederick Woodley PhD & Peter L. Lu MD, MS

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  1. Zeyad M. Abdulkader MD
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This article is part of the Topical Collection on Pediatric Gastroenterology

The original online version of this article was revised due to error on the second author name. ‘Frederick Woodley’ was incorrectly written as ‘Fredrick Woodley’.

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Abdulkader, Z.M., Woodley, F. & Lu, P.L. Extra-esophageal Manifestations of Pediatric Gastroesophageal Reflux Disease: Updated Review. Curr Treat Options Peds 7, 217–228 (2021). https://doi.org/10.1007/s40746-021-00229-4

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