Recommendations of the Croatian Society for Pediatric gastroenterology, hepatology and nutrition guidelinesfor evaluation and treatment of gastroesophageal reflux disease in infants ad children

Involuntary reflux of the gastric content into the esophagus is a physiological, every-day occurrence. If it causes structural damage to the esophagus or symptoms, gastroesophageal reflux disease has occurred. The main symptoms are different in infants and older children and can be primarily related to the gastrointestinal system, the respiratory system, or occasionally to the nervous system or other organs. To distinguish gastroesophageal reflux as a physiological state from gastroesophageal reflux disease a thorough history and physical examination is needed. The definitive diagnosis is confirmed by selective diagnostic procedures, following algorithms according to the child's age and leading symptoms. The treatment of choice depends on the stage of the gastroesophageal reflux. The first line of treatment can be given in primary care and consists of habitual changes, antacids and avoiding drugs that lower the tone of the gastroesophageal sphincter. Further therapeutic measures (medication or surgery) should be given only following a specialist’s advice.