Pedıatrıc Gastroesophageal Reflux Dısease: Clınıc, Dıagnosıs And Treatment

Yıl 2018, Cilt: 10 Sayı: 1, 30 - 38, 21.01.2018

Prof. Dr. Deniz Ertem

Öz

Abstract

Gastroesophageal reflux (GER) is defined as the involuntary retrograde passageof gastric contents into the esophagus with or without regurgitation or vomiting. GERis a normal physiologic process occurring several times per day in healthy infants.Gastroesophageal reflux disease (GERD) occurs when reflux of the gastric contentscauses symptoms that affect the quality of life or pathologic complications, such asfailure to thrive, feeding or sleeping problems, chronic respiratory disorders, esophagitis, hematemesis, apnea and apparent life-threatening events. A reflux symptomin children, unlike adults, varies according to age group. History and physical examination is the gold standard for the diagnosis of GERD. It is important to definewhich children have GERD to offer optimal treatment and to avoid costly and potentially invasive diagnostic testing. The recommendation on management ofGERD in children has always been a step-up approach, starting with parental reassurance, positional treatment, dietary recommendations, medical or surgical therapy.  Atypical presentations, complicated GER or failure to response to empiric management are indications for further diagnostic evaluations.

Anahtar Kelimeler

astroesophageal reflux, gastroesophageal reflux disease, children

Pediatrik Gastroösofageal Reflü Hastalığı: Klinik, Tanı ve Tedavi

Öz

Öz

Gastroösofageal reflü (GÖR); sağlıklı bireylerde mide içeriğinin regürjitasyon yada kusma olmaksızın istemsiz olarak ösofagusa geçişi olarak tanımlanır. GÖR, sağ-lıklı infantlarda günde birkaç kez olabilen fizyolojik bir durumdur. Gastroösofageal reflü hastalığı (GÖRH) ise; hayat kalitesini etkileyen ya da büyüme-gelişme geriliği, beslenme/uyku problemleri, kronik solunum yolu hastalıkları, ösofajit, hematemez, apne ve akut hayat tehdit edici olay (ALTE) gibi komplikasyonlara neden olabilen patolojik bir tablodur. Erişkinlerden farklı olarak çocuklarda reflü semptomları yaş gruplarına göre değişiklik gösterir. Detaylı öykü ve dikkatli fizik muayenetanıda ve GÖRH'na bağlı olası komplikasyonları değerlendirmede en önemli basamaklardır. GÖR ya da GÖRH tanısında gereksiz incelemelerden ve tedavilerden kaçınmaya dikkat edilirken, sekonder reflü nedenleri ve olası komplikasyonlar göz ardıedilmeden hasta değerlendirilmelidir. GÖRH yönetiminde aile eğitimi, pozisyoneltedavi, diyetin düzenlenmesi, medikal ya da cerrahi tedavi yaklaşımları şeklinde tedavi basamakları uygulanır. Atipik klinik tablo, komplike olmuş GÖRH varlığındaya da ampirik tedaviye yeterli cevap alınamazsa ileri inceleme yapılması gereklidir.

Anahtar Kelimeler

Gastroösofageal reflü, gastroöso-fageal reflü hastalığı, çocuk

Kaynakça

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