Gastro-oesophageal reflux disease in children: NICE guidance.

#### The bottom line Gastro-oesophageal reflux is a normal physiological event, whereas gastro-oesophageal reflux disease (GORD) occurs when this process causes symptoms severe enough to merit medical treatment or when there are associated complications. In infants and children it is particularly difficult to differentiate between the two conditions because of the wide variety of potential symptoms and the lack of a simple, reliable, and widely available diagnostic test. The true burden of the problem is therefore difficult to quantify, and it is accepted that clinical practice varies greatly. Children affected by the disease include premature and term neonates, otherwise well infants and children, and those with known risk factors, such as repaired diaphragmatic hernia and other congenital anomalies or severe neurodisabilities. This last group of children may have complex comorbidities and the underlying pathophysiology may have important differences. This article summarises the most recent guidance from the National Institute for Health and Care Excellence (NICE) on how to recognise, diagnose, and manage gastro-oesophageal reflux disease in infants, children, and young people. …