Table 2.

The signs and symptoms of gastroesophageal reflux disease and alarm features of its most significant mimics

Symptoms	Signs	Red flags from other serious conditions that may underlie or mimic GERD
General	General	General
Irritability	Dental erosion, not dental caries (Figure 2)	Excessive irritability
Failure to thrive	Anemia	Weight loss
Feeding refusal		Fever
Sandifer syndrome		Lethargy
Gastrointestinal	Gastrointestinal	Gastrointestinal
Recurrent regurgitation	Esophagitis	Onset of regurgitation at > 6 mo of age
Recurrent vomiting	Esophageal stricture	Persistent or progressive regurgitation at > 1 yr of age
Heartburn	Barrett esophagus	Vomiting: Persistent forceful, nocturnal or bilious vomiting
Dysphagia/odynophagia		Hematemesis
Epigastric pain		Marked abdominal distension
Airway	Airway	Neurological
Difficult to treat wheezing	Apnea	Bulging fontanelle
Unexplained stridor	Recurrent pneumonia	Seizure
Chronic cough	Recurrent otitis media	Macro/microcephaly
Hoarseness of voice		Neurological abnormalities
		Papilledema

GERD: Gastroesophageal reflux disease.