It is difficult to know the true natural history of GER in infants and children because most patients obtain treatment. Knowledge on the natural history in untreated patients from the initial studies, when effective treatment was unavailable, is extremely limited, because of the limited description and identification of the patients. The paucity of long-term reports, the presence of multiple pathogenic factors and the absence of patho-gnomonic symptoms for complications make it currently impossible to predict, on an individual basis, which child will continue to have GERD into and during adult life. However, we know that untreated GERD may be associated with severe complications such as esophagitis, failure to thrive in children, esophageal stricture and Barrett's esophagus.
Recent observations suggest a decreased quality of life in regurgitating infants and their parents, even if the regurgitation has disappeared. A 10-year follow-up of esophagitis showed that over 70% had persisting symptoms, and 2% had strictures.19 Untreated or uncontrolled GERD is associated with severe complications such as esophagitis, Barrett's mucosa, stricture formation and esophageal adenocarcinoma. The frequency, severity and duration of reflux symptoms are related to the risk of esophageal cancer. It is not known whether mild esophagitis or GERD symptoms persisting from childhood into adulthood carry an increased risk for severe complications in adult life. Spontaneous improvement and healing of non-ulcerated esophagitis may exist. Nevertheless, complications and side-effects of medication have to be considered in relation to the natural evolution of untreated GERD.
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Gastroesophageal reflux disease is the medical term for what we know as acid reflux. Acid reflux occurs when the stomach releases its liquid back into the esophagus, causing inflammation and damage to the esophageal lining. The regurgitated acid most often consists of a few compoundsbr acid, bile, and pepsin.