[Long-term observation of children with gastro-esophageal reflux disease].

Introduction: Gastroesophageal reflux disease (GERD) is frequent disorder of the gastro-intestinal tract. Although in adults GERD is regarded as a chronic disease, in children it is often considered as a transient disorder.

Aim: To assess the natural history of GERD in infants and children.

Material And Methods: We enrolled 163 children (44% girls and 56% boys) with GERD diagnosed on the basis of esophageal symptoms and positive result of 24-hour pH-monitoring (fraction time - fT > 4.2%). The mean age at the time of the diagnosis was 4.5 year. After 3.5 years from the diagnosis, the patients or guardians filled in a custom-made questionnaire evaluating GERD symptoms: heartburn, belching, vomiting, regurgitations, feeding problems, dysphagia, epigastric pain. Control pH-monitoring was performed in 71 of the patients. The patients were divided into three age groups: group I--below 1 year of age (38 children), group II--between 1 and 4 years of age (35 children) and group III--above 4 years of age (90 children).

Results: GERD symptoms disappeared completely in 45%, 14.3% and 13.4% from group I, II and III, respectively. In 38 (54%) patients the control pH-monitoring revealed pathologic acid reflux, including 4 children without any GERD symptoms.

Conclusions: The study shows that in children aged above 1 year GERD symptoms are unlikely to subside completely. Moreover, acid gastroesophageal reflux may still be present, despite the absence of the clinical symptoms.