What are the clinical manifestations of gastroesophageal reflux in children?

  Gastroesophageal reflux (GER) is the reflux of gastric contents into the esophagus and even the oropharynx, with vomiting as the main clinical manifestation, which can cause a series of intra- and extra-esophageal symptoms and/or complications that need to be evaluated and treated. The clinical manifestations of gastroesophageal reflux in children are diverse and can be broadly classified into three categories: typical symptoms, atypical symptoms and extra-digestive symptoms.  Typical symptoms: vomiting is the main symptom, infants and young children: milk spillage, regurgitation; older children: acid reflux, regurgitation, belching, burning sensation behind the sternum or under the saber, and in severe cases, vomiting blood and black stool.  2. Atypical symptoms: refusal of food/difficulty in swallowing, epigastric pain, chest pain, weight loss or no gain, poor growth, anemia, irritability, night terrors.  3. Extra-digestive symptoms: refractory bronchial asthma, recurrent pneumonia, apnea or sudden infant death syndrome, wheezing, hoarseness, chronic cough; chronic pharyngitis, otitis media, sinusitis, oral ulcers, etc.  Children who present with atypical symptoms or symptoms outside the digestive tract should be taken seriously by the clinician.