In children and adolescents, gastroesophageal reflux disease (GERD) is a common condition that develops when gastric contents (ie, food and acid) flow back into the esophagus or mouth. It may be symptomatic or asymptomatic (silent reflux). Symptoms are similar to those observed in adults and most commonly include heartburn, regurgitation, chronic cough, and sore throat. In this population, special consideration should also be given to poor weight gain, nighttime cough, and fussiness at mealtimes.

Patients with chronic cough and impaired mucosal clearance (eg, cystic fibrosis) and esophageal dysmotility (eg, esophageal atresia following repair) are predisposed to GERD.

The prevalence of pediatric GERD is not as well characterized as in adults. GERD is thought to be less common in children aged 18 months to 10 years. Frequent (weekly) GERD symptoms have been reported in 0.5%-3.2% of children aged younger than 10 years. Prevalence begins to approach more typical adult rates as children age, with a prevalence of about 10% in children aged 10-18 years.

As with adult patients, those presenting with typical symptoms can be presumed to have GERD and treated empirically. If left untreated, complications such as dental erosion, Barrett esophagus, and adenocarcinoma can arise.