Gastroesophageal reflux disease. International evidence-based consensus on the definition of GERD in children and adolescents

Abstract

An international consensus on the definition of gastroesophageal reflux disease (GERD) in pediatrics was sought.After a systematic literature search, a set of key statements was developed by an international panel of pediatric gastroenterologists and voted anonymously in a modified Delphi process. the strength of each statement was assessed using the GRADE system.Consensus was reached on 98% of the 59 statements. Consensus items of particular note were: (1) GERD is present when reflux of gastric contents causes troublesome symptoms and/or complications. the definition is restricted in the case of children under similar to 8 years, due to unreliable reporting of incriminating symptoms; (2) the primary role of histology is to exclude other conditions, rather than to establish the diagnosis of GERD; (3) Barrett's esophagus characterizes an esophageal metaplasia that is intestinal metaplasia-positive or -negative; (4) extraesophageal conditions may be associated with GERD, but for most of these conditions causality remains to be established.The consensus statements were developed by means of a rigorous process and can form the basis for clinical trials and practice guidelines.