Refluxo gastroesofágico no primeiro ano de vida: fisiológico ou patológico?

Abstract

Gastroesophageal reflux (GER) is defined as the involuntary return of the gastric contents to the esophagus, being a common condition in the first year of life, with a peak incidence at 4 months of age and spontaneous resolution in approximately 80 to 95% of cases until 12 to 14 months. Its management is still considered a challenge due to difficulties in differentiating whether it is physiological or pathological. Physiological GER requires no drug intervention in most patients. The teaching to the parents and the modifications in postural and / or dietary are the best therapeutic approaches for infantile regurgitation. When reflux is accompanied by complications or discomfort it is defined as gastroesophageal reflux disease (GERD) and usually requires diagnostic investigation and drug treatment. New guidelines from the North American and European Societies of Pediatric Gastroenterology, Hepatology and Nutrition were implemented in 2009 to guide the clinical management of reflux. In recent years, there have been no significant changes in diagnostic and therapeutic modalities, so careful clinical evaluation associated with good family relationship remains the most effective way to care for reflux in the infant.