What factors predispose to pediatric gastroesophageal reflux?

Updated: Mar 14, 2019
  • Author: Steven M Schwarz, MD, FAAP, FACN, AGAF; Chief Editor: Carmen Cuffari, MD  more...
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Other factors that predispose individuals to gastroesophageal reflux include the following:

  • Medications - Eg, diazepam, theophylline; methylxanthines exacerbate reflux secondary to decreased sphincter tone.

  • Smoking

  • Alcohol

  • Poor dietary habits - Eg, overeating, eating late at night, assuming a supine position shortly after eating

  • Food allergies

  • Certain foods - Eg, greasy, highly acidic

  • Motility disorders (postulated to potentially cause reflux) - These include antral dysmotility and delayed gastric emptying; such disorders are considered functional problems and frequently do not have an identifiable anatomic or organic cause

  • Transient lower esophageal sphincter relaxation (tLESR) - This is currently believed to be the main mechanism of gastroesophageal reflux, accounting for 94% of reflux episodes in children and adults; poor basal LES tone was previously thought to be a cause

  • Obesity -Obesity has been cited as a major risk factor for gastroesophageal reflux; in studies conducted with adult patients, weight loss has been demonstrated to be one of the lifestyle modifications that can decrease the severity and frequency of reflux

  • Supine position

  • Decreased gastric emptying and reduced acid clearance from the esophagus - These can cause abnormal reflux

  • Neurodevelopmental disabilities - Children with neurodevelopmental disabilities, including cerebral palsy, Down syndrome, and other heritable syndromes associated with developmental delay, have an increased prevalence of gastroesophageal reflux

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