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Gastroesophageal Reflux
Steven J. Kraus, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Clinical Issues

        • Diagnostic Checklist

          TERMINOLOGY

          • Abbreviations

            • Gastroesophageal reflux (GER), GER disease (GERD)
          • Definitions

            • GER: Retrograde flow of gastric contents into esophagus
              • Physiologic phenomenon, especially in young infants
            • GERD: GER causes clinical symptoms or tissue damage

          IMAGING

          • General Features

            • Radiographic Findings

              • Fluoroscopic Findings

                • MR Findings

                  • Ultrasonographic Findings

                    • Nuclear Medicine Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        Selected References

                                        1. Expert Panel on Pediatric Imaging. et al: ACR Appropriateness Criteria® vomiting in infants. J Am Coll Radiol. 17(11S):S505-15, 2020
                                        2. Seif Amir Hosseini A et al: Real-time MRI for dynamic assessment of gastroesophageal reflux disease: comparison to pH-metry and impedance. Eur J Radiol. 125:108856, 2020
                                        3. Koivusalo AI et al: Outcome of surgery for pediatric gastroesophageal reflux: clinical and endoscopic follow-up after 300 fundoplications in 279 consecutive patients. Scand J Surg. 107(1):68-75, 2018
                                        4. Uslu Kızılkan N et al: Comparison of multichannel intraluminal impedance-pH monitoring and reflux scintigraphy in pediatric patients with suspected gastroesophageal reflux. World J Gastroenterol. 22(43):9595-603, 2016
                                        5. Liu YW et al: The correlation between endoscopic reflux esophagitis and combined multichannel intraluminal impedance-pH monitoring in children. Pediatr Neonatol. 57(5):385-9, 2015
                                        6. Vandenplas Y et al: An updated review on gastro-esophageal reflux in pediatrics. Expert Rev Gastroenterol Hepatol. 9(12):1511-21, 2015
                                        7. Ferreira CT et al: Gastroesophageal reflux disease: exaggerations, evidence and clinical practice. J Pediatr (Rio J). 90(2):105-18, 2014
                                        8. Codreanu I et al: Effects of the frame acquisition rate on the sensitivity of gastro-oesophageal reflux scintigraphy. Br J Radiol. 86(1026):20130084, 2013
                                        9. Knatten CK et al: Gastric emptying in children with gastroesophageal reflux and in healthy children. J Pediatr Surg. 48(9):1856-61, 2013
                                        10. Lightdale JR et al: Gastroesophageal reflux: management guidance for the pediatrician. Pediatrics. 131(5):e1684-95, 2013
                                        11. Fike FB et al: Diagnosis of gastroesophageal reflux disease in infants. Pediatr Surg Int. 27(8):791-7, 2011
                                        12. Machado RS et al: Gastric emptying evaluation in children with erosive gastroesophageal reflux disease. Pediatr Surg Int. 26(5):473-8, 2010
                                        13. Valusek PA et al: Does an upper gastrointestinal study change operative management for gastroesophageal reflux? J Pediatr Surg. 45(6):1169-72, 2010
                                        14. Tannuri AC et al: Gastroesophageal reflux disease in children: efficacy of Nissen fundoplication in treating digestive and respiratory symptoms. Experience of a single center. Dis Esophagus. 21(8):746-50, 2008
                                        15. Baker ME et al: Gastroesophageal reflux disease: integrating the barium esophagram before and after antireflux surgery. Radiology. 243(2):329-39, 2007
                                        16. Boyle JT: Gastroesophageal reflux disease in 2006. The imperfect diagnosis. Pediatr Radiol. 36 Suppl 2:192-5, 2006
                                        17. Canon CL et al: Surgical approach to gastroesophageal reflux disease: what the radiologist needs to know. Radiographics. 25(6):1485-99, 2005
                                        18. Demirbilek S et al: Delayed gastric emptying in gastroesophageal reflux disease: the role of malrotation. Pediatr Surg Int. 21(6):423-7, 2005
                                        19. Gold BD: Review article: epidemiology and management of gastro-oesophageal reflux in children. Aliment Pharmacol Ther. 19 Suppl 1:22-7, 2004
                                        20. Tolia V et al: Gastroesophageal reflux disease: review of presenting symptoms, evaluation, management, and outcome in infants. Dig Dis Sci. 48(9):1723-9, 2003
                                        21. El-Serag HB et al: Endoscopic manifestations of gastroesophageal reflux disease in patients between 18 months and 25 years without neurological deficits. Am J Gastroenterol. 97(7):1635-9, 2002
                                        22. Gremse DA: Gastroesophageal reflux disease in children: an overview of pathophysiology, diagnosis, and treatment. J Pediatr Gastroenterol Nutr. 35 Suppl 4:S297-9, 2002
                                        23. Jang HS et al: Correlation of color Doppler sonographic findings with pH measurements in gastroesophageal reflux in children. J Clin Ultrasound. 29(4):212-7, 2001
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Clinical Issues

                                              • Diagnostic Checklist

                                                TERMINOLOGY

                                                • Abbreviations

                                                  • Gastroesophageal reflux (GER), GER disease (GERD)
                                                • Definitions

                                                  • GER: Retrograde flow of gastric contents into esophagus
                                                    • Physiologic phenomenon, especially in young infants
                                                  • GERD: GER causes clinical symptoms or tissue damage

                                                IMAGING

                                                • General Features

                                                  • Radiographic Findings

                                                    • Fluoroscopic Findings

                                                      • MR Findings

                                                        • Ultrasonographic Findings

                                                          • Nuclear Medicine Findings

                                                            • Imaging Recommendations

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  • Microscopic Features

                                                                    CLINICAL ISSUES

                                                                    • Presentation

                                                                      • Demographics

                                                                        • Natural History & Prognosis

                                                                          • Treatment

                                                                            DIAGNOSTIC CHECKLIST

                                                                            • Consider

                                                                              Selected References

                                                                              1. Expert Panel on Pediatric Imaging. et al: ACR Appropriateness Criteria® vomiting in infants. J Am Coll Radiol. 17(11S):S505-15, 2020
                                                                              2. Seif Amir Hosseini A et al: Real-time MRI for dynamic assessment of gastroesophageal reflux disease: comparison to pH-metry and impedance. Eur J Radiol. 125:108856, 2020
                                                                              3. Koivusalo AI et al: Outcome of surgery for pediatric gastroesophageal reflux: clinical and endoscopic follow-up after 300 fundoplications in 279 consecutive patients. Scand J Surg. 107(1):68-75, 2018
                                                                              4. Uslu Kızılkan N et al: Comparison of multichannel intraluminal impedance-pH monitoring and reflux scintigraphy in pediatric patients with suspected gastroesophageal reflux. World J Gastroenterol. 22(43):9595-603, 2016
                                                                              5. Liu YW et al: The correlation between endoscopic reflux esophagitis and combined multichannel intraluminal impedance-pH monitoring in children. Pediatr Neonatol. 57(5):385-9, 2015
                                                                              6. Vandenplas Y et al: An updated review on gastro-esophageal reflux in pediatrics. Expert Rev Gastroenterol Hepatol. 9(12):1511-21, 2015
                                                                              7. Ferreira CT et al: Gastroesophageal reflux disease: exaggerations, evidence and clinical practice. J Pediatr (Rio J). 90(2):105-18, 2014
                                                                              8. Codreanu I et al: Effects of the frame acquisition rate on the sensitivity of gastro-oesophageal reflux scintigraphy. Br J Radiol. 86(1026):20130084, 2013
                                                                              9. Knatten CK et al: Gastric emptying in children with gastroesophageal reflux and in healthy children. J Pediatr Surg. 48(9):1856-61, 2013
                                                                              10. Lightdale JR et al: Gastroesophageal reflux: management guidance for the pediatrician. Pediatrics. 131(5):e1684-95, 2013
                                                                              11. Fike FB et al: Diagnosis of gastroesophageal reflux disease in infants. Pediatr Surg Int. 27(8):791-7, 2011
                                                                              12. Machado RS et al: Gastric emptying evaluation in children with erosive gastroesophageal reflux disease. Pediatr Surg Int. 26(5):473-8, 2010
                                                                              13. Valusek PA et al: Does an upper gastrointestinal study change operative management for gastroesophageal reflux? J Pediatr Surg. 45(6):1169-72, 2010
                                                                              14. Tannuri AC et al: Gastroesophageal reflux disease in children: efficacy of Nissen fundoplication in treating digestive and respiratory symptoms. Experience of a single center. Dis Esophagus. 21(8):746-50, 2008
                                                                              15. Baker ME et al: Gastroesophageal reflux disease: integrating the barium esophagram before and after antireflux surgery. Radiology. 243(2):329-39, 2007
                                                                              16. Boyle JT: Gastroesophageal reflux disease in 2006. The imperfect diagnosis. Pediatr Radiol. 36 Suppl 2:192-5, 2006
                                                                              17. Canon CL et al: Surgical approach to gastroesophageal reflux disease: what the radiologist needs to know. Radiographics. 25(6):1485-99, 2005
                                                                              18. Demirbilek S et al: Delayed gastric emptying in gastroesophageal reflux disease: the role of malrotation. Pediatr Surg Int. 21(6):423-7, 2005
                                                                              19. Gold BD: Review article: epidemiology and management of gastro-oesophageal reflux in children. Aliment Pharmacol Ther. 19 Suppl 1:22-7, 2004
                                                                              20. Tolia V et al: Gastroesophageal reflux disease: review of presenting symptoms, evaluation, management, and outcome in infants. Dig Dis Sci. 48(9):1723-9, 2003
                                                                              21. El-Serag HB et al: Endoscopic manifestations of gastroesophageal reflux disease in patients between 18 months and 25 years without neurological deficits. Am J Gastroenterol. 97(7):1635-9, 2002
                                                                              22. Gremse DA: Gastroesophageal reflux disease in children: an overview of pathophysiology, diagnosis, and treatment. J Pediatr Gastroenterol Nutr. 35 Suppl 4:S297-9, 2002
                                                                              23. Jang HS et al: Correlation of color Doppler sonographic findings with pH measurements in gastroesophageal reflux in children. J Clin Ultrasound. 29(4):212-7, 2001