Gastroesophageal reflux (GER) is a common event in the first year of life and it mainly causes regurgitation and/or vomiting episodes in an otherwise thriving infant. Reflux is the involuntary passage of gastric contents into the esophagus and occurs in the majority of infants.
Regurgitation, where gastric contents reflux into the oral cavity, is the most common symptom and occurs at least once a day in a third of infants at 4 month of age.

Generally, parents poorly tolerate this clinical condition. It is responsible for parental anxiety and consequently for multiple visits to the pediatrician. Uncomplicated GER in infants is considered as a self-limited process treated with thickened feeds, positional treatment and parental reassurance without performing any further investigation.

GER becomes GERD when associated with complications and additional manifestations:

Gastroesophageal reflux disease (GERD) is clearly considered a pathological condition characterized by regurgitation and/or vomiting associated with poor weight gain, esophagitis, respiratory symptoms, signs and symptoms of distressed behaviour and other complications.
Moreover, Gastroesophageal reflux disease may be a secondary manifestation of other conditions such as a food allergy, i.e. secondary Gastroesophageal Reflux Disease.

Certain indicators will strongly suggest secondary Gastroesophageal Reflux Disease (GERD) such as:

• other symptoms typical of allergy eg. diarrhoea or eczema;
• allergic symptoms in first degree relatives;
• appearance of symptoms upon formula change/weaning;
• lack of response to acid suppression therapy.

Cow Milk Allergy and therapy of Gastroesophageal Reflux Disease…

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