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- Effortless regurgitation of gastric contents. Occurs physiologically at all ages, and most episodes are brief and asymptomatic
- Divided into physiologic and pathologic processes:
- Some degree of physiologic gastroesophageal reflux (GER) is normal at all ages.
- Physiologic infant reflux (normal GER of infancy) is very common. Symptoms peak around 4 months of age and generally have resolved by 1 year of age.
- Pathologic reflux or gastroesophageal reflux disease (GERD) is defined by troublesome symptoms or complications of GER.
- Complications may include reflux esophagitis, bleeding, esophageal stricture, failure to thrive, chronic/recurrent respiratory tract disease, or vomiting.
- Pathologic GERD: 10% of adults, 2–8% of children
- Neurologic disorders (cerebral palsy/quadriplegia)
- Esophageal atresia
- Tracheoesophageal fistula
- Cystic fibrosis
- Hiatal hernia
Transient relaxation of the lower esophageal sphincter during episodes of increased abdominal and gastric pressure. GERD is a multifactorial process involving number of reflux events, acidity, esophageal clearance, gastric emptying, mucosal barriers, visceral hypersensitivity, and airway responsiveness.