GASTROESOPHAGEAL REFLUX DISEASE (GERD) IN CHILDREN: CLINICAL FEATURES, RESPIRATORY COMPLICATIONS, AND MANAGEMENT

Abstract

Gastroesophageal reflux disease (GERD) is a common chronic relapsing disorder of the upper gastrointestinal tract in children, characterized by both esophageal and extraesophageal manifestations. Over the past decade, the incidence of GERD has shown a notable increase in the pediatric population, while the prevalence of gastritis, gastroduodenitis, and peptic ulcers has remained relatively stable. GERD pathogenesis is multifactorial, involving dysfunction of the lower esophageal sphincter, impaired esophageal clearance, increased gastric acidity, and elevated intra-abdominal pressure. Clinical manifestations range from heartburn, regurgitation, and dysphagia to extraesophageal symptoms including bronchopulmonary, otolaryngological, cardiological, and dental disorders.

Bronchopulmonary complications, such as asthma, chronic bronchitis, and recurrent pneumonia, are particularly significant and often related to microaspiration or neural reflex mechanisms. Diagnosis requires comprehensive gastroenterological and pulmonological evaluation, including endoscopy, 24-hour pH monitoring, spirometry, and bronchoprovocation tests. Management emphasizes lifestyle and dietary modifications, pharmacotherapy with proton pump inhibitors and prokinetics, and targeted treatment of respiratory complications. Early recognition and tailored therapy are critical to improving quality of life and reducing disease burden in affected children.