gastric reflex in youngA new guideline published by the National Institute for Health and Care Excellence (NICE) will help doctors treat gastro-oesophageal reflux disease (GORD) in infants, children and young people more effectively.

Reflux is normal and is characterised by visibly regurgitating food after eating. It is most common in babies – affecting 4 in 10 infants – but can happen to almost everyone at some point in their lives. GOR usually becomes less frequent with time; symptoms tend to disappear in 90% of affected infants before they are 1 year old.

Professor Mark Baker, Director for the Centre for Clinical Practice at NICE, said: “It can be difficult to differentiate between ‘normal’ episodes of reflux and more serious GORD, but this new NICE guideline will support medical professionals to make the correct diagnosis. It will mean infants, children and young people get the care that they need while also avoiding over-treating healthy children.”

GORD can happen for different reasons, but is most commonly caused by a ring of muscle towards the bottom of the oesophagus (the lower oesophageal sphincter) failing to work properly. This ring is designed to act like a valve, opening to let food fall into the stomach then closing to prevent acid leaking out of the stomach. In GORD, this ‘valve’ doesn’t close properly, allowing acid to leak out.

Health professionals should support and advise families on the difference between GOR and GORD, Professor Baker said. “GOR and GORD in infants, children and young people, although common, can be very distressing. Parents and carers can feel helpless and may feel like their fears or concerns are being dismissed.”

“Healthcare professionals should reassure families but also take all concerns seriously. If not treated, GORD can lead to malnutrition in children, cause ulcers in the oesophagus and can have psychological effects on a child’s relationship with food. GORD can be treated well with medication, so specialist referrals should be given to those children whose symptoms persist.”