TY - JOUR T1 - Update on drugs for gastro-oesophageal reflux disease JF - Archives of disease in childhood - Education & practice edition JO - Arch Dis Child Educ Pract Ed SP - ep114 LP - ep118 DO - 10.1136/adc.2006.106328 VL - 92 IS - 4 AU - Simon Keady Y1 - 2007/08/01 UR - http://ep.bmj.com/content/92/4/ep114.abstract N2 - Gastro-oesophageal reflux (GOR) is a common and usually self-limiting condition involving the regurgitation of gastric contents into the oesophagus. It causes symptoms (table 1) such as heartburn, oesophagitis, acute life-threatening events and respiratory disease,1–3 at which point it is defined as gastro-oesophageal reflux disease (GORD).View this table:In this windowIn a new window Table 1  Symptoms of gastro-oesophageal reflux disease (GORD) The prevalence of GOR and GORD in infants is between 20–40%, higher than that in children and adults. This high number is associated with the transient immaturity of the oesophagus and the stomach. Features include a short abdominal oesophagus (<1 cm), increased oesophageal clearance, increased number of transient lower oesophageal sphincter relaxations coupled with delayed gastric emptying.4–6 Methods of detection include oesophageal pH monitoring, especially with respiratory manifestations,1,3,7–9 or multiple intraluminal impedance.10–12 The latter allows detection of continued postprandial reflux despite a neutralisation of gastric contents by milk formula. However, there continues to be a wide variation in diagnostic and management strategies even across major neonatal intensive care units in the UK, requiring further work to evaluate appropriateness and effectiveness.13 The principal aims of treatment are to alleviate symptoms, allow healing of the oesophageal mucosa if indicated, manage and prevent any complications and to maintain long-term remission. Treatment strategies and options depend upon the severity of the GORD and may include lifestyle changes or pharmacological and surgical interventions. Older children and young people should be counselled on specific lifestyle changes such as weight reduction if obese and the avoidance of smoking and drinking alcohol if necessary. For the purpose of this article, the focus will primarily be on drug management of this condition (table 2).View this table:In this windowIn a new window Table 2  Summary of drugs used to treat GOR and GORD Normal steps in the management of mild conditions are usually non-pharmacological and may involve … ER -