Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN)

. Author manuscript; available in PMC: 2019 Mar 1.

Published in final edited form as: J Pediatr Gastroenterol Nutr. 2018 Mar;66(3):516–554. doi: 10.1097/MPG.0000000000001889

Question 1:	What is the definition of GER/GERD in infants and children 0–18 years?
Question 2:	What are the “red flag” findings and diagnostic clues to distinguish infants and children with GERD (or conditions other than GERD), from GER?
Question 3:	What diagnostic interventions have additional value to history taking and physical examination in infants and children with suspected GERD?
Question 4:	What non-pharmacologic treatment options are effective and safe for the reduction of signs and symptoms of GERD?
Question 5:	What are effective and safe pharmacologic treatment options for the reduction of signs and symptoms of GERD
Question 6:	Which infants and children would benefit from surgical treatment such as fundoplication and what are the efficacies of other surgical therapies for GERD?
Question 7:	What is the prognosis of GERD in infants and children and what are prognostic factors?
Question 8:	What is the appropriate evaluation of infants and children 0–18 years with GERD refractory to non-pharmacological and pharmacological treatment?

PPI = proton pump inhibitor; pH-MII = pH multichannel intraluminal impedance; H2 = histamine receptor H2