Gastro-oesophageal reflux (GORD)

Gastro-oesophageal reflux occurs when there is inappropriate effortless passage of gastric contents into the oesophagus. GORD exists when reflux is repeated and severe enough to cause harm. Reflux is very common in infancy and is associated with slow gastric emptying, liquid diet (milk), horizontal posture, and low resting lower oesophageal sphincter (LOS) pressure.

Other causes in infancy and in older children include: LOS dysfunction (e.g. hiatus hernia); ↑ gastric pressure (e.g. delayed gastric emptying); external gastric pressure; gastric hypersecretion (e.g. acid); food allergy; and CNS disorders (e.g. cerebral palsy).

Prognosis

Vast majority of infants outgrow symptoms by 1 year. In older children, a chronic relapsing course requires investigations to identify and treat underlying conditions.