Dietary Therapy in Gastroesophageal Reflux Disease: From Infancy to Adolescence

Gastroesophageal reflux (GER) is usually a self-resolving phenomenon during infancy, however, some intervention is frequently needed to allay parental anxiety and stress. Older children and adolescents need dietary advice in addition to pharmacologic intervention because they are more likely to have gastroesophageal reflux disease. Management depends on the age and severity of the child's symptoms. In infants with mild symptoms, attention to feeding technique, volume, frequency, use of pre-thickened formula and an upright position for at least 30 minutes after a feeding may suffice. If food allergy is suspected, a 2-4 week trial of a hydrolysed formula may be appropriate. Older children and adolescents may benefit from a combination of dietary and lifestyle measures.Encouraging small, frequent meals and avoidance of foods identified to cause symptoms is an obvious consideration. In presence of obesity, weight loss may improve GER symptoms. Since unnecessary dietery restrictions impair the quality of life for patients and parents, a rational, nutritional therapeutic approach is recommended.