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GER and GERD are frequent conditions in infants, children and adolescents. Symptomatology differs with age, although the main pathophysiological mechanism, transient relaxations of the LES associated with reflux, is identical at all ages. Although infant regurgitation is likely to disappear with age, little is known about reflux. The majority of symptomatic reflux episodes are acid, but non-acid and gas reflux can also cause symptoms. Complications of reflux disease may be severe and even life threatening, such as esophageal stenosis and Barrett's esophagus. There is no gold standard for a diagnostic technique. A simple questionnaire may be among the best diagnostic aids in infants; non-acid reflux is best investigated with impedancometry. Primary GERD is mainly a motility disorder. Guidelines for treatment struggle with the fact that there is no prokinetic drug with a convincing efficacy profile. As a consequence, treatment of GERD focuses on anti-acid drugs, and particularly on PPIs. There is little or no information on how to organize follow-up.


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