Reflux esophagitis in infants and children: a report from the Working Group on Gastro-Oesophageal Reflux Disease of the European Society of Paediatric Gastroenterology and Nutrition

In this article, the Working Group on Gastro-Oesophageal Reflux of the European Society of Paediatric Gastroenterology and Nutrition presents and discusses a definition of reflux esophagitis and recommends a diagnostic approach and therapeutic management for this condition. Histologic criteria for reflux esophagitis, modified and adapted to the particular needs of infants and children, are suggested. Upper gastrointestinal endoscopy is recommended as the technique of choice in infants and children presenting with symptoms suggestive of reflux esophagitis. Prokinetics, although still a relatively new drug family, have already established a definitive place in the treatment of gastroesophageal reflux disease in infants and children and could also be used in the treatment of nonulcerative esophagitis, as suggested in the literature. If the esophagitis is more severe (ulcerative), treatment should initially consist of H2 blockers and then be continued with prokinetics. New drugs, such as omeprazole, are suggested in cases refractory to H2 blockers. Surgery is indicated in life-threatening conditions or if the esophagitis is resistant to adequate medical management.