Prevalence of Gastroesophageal Reflux Disease Symptoms in Infants and Children: A Systematic Review

Objectives: Gastroesophageal reflux disease (GERD) is defined as GER causing troublesome symptoms or complications. In this study we reviewed the literature regarding the prevalence of GERD symptoms in infants and children. Methods: Databases of PubMed, EMBASE and Cochrane were systematically searched from inception to June 26, 2018. English-written studies based on birth cohort, school based or general population samples of ≥50 children aged 0–21 years were included. Convenience samples were excluded. Results: In total, 3581 unique studies were found, of which 25 studies (11 in infants and 14 in children) were included with data on the prevalence of GERD symptoms comprising a total population of 487969 children. In infants (0–18 months), GERD symptoms 1) are present in more than a quarter of infants on a daily basis and 2) show a steady decline in frequency with almost complete disappearance of symptoms at the age of 12 months. In children >18 months, GERD symptoms show large variation in prevalence between studies (range 0%-38% of study population) and overall, are present in more than 10% and in 25% on respectively a weekly and monthly basis. Of the risk factors assessed, higher BMI and the use of alcohol and tobacco were associated with higher GERD symptom prevalence. Conclusions: This systematic review demonstrates that the reported prevalence of GERD symptoms varies considerably, depending on method of data collection and criteria used to define symptoms. Nevertheless, the high reported prevalence rates support better investment of resources and educational campaigns focused on prevention. Address correspondence and reprint requests to Maartje Singendonk, MD, Emma Children's Hospital/Amsterdam UMC – location AMC, C2–312, PO Box 22700, 1100 DD Amsterdam, The Netherlands (e-mail: m.m.j.singendonk@amc.uva.nl). Received 29 October, 2018 Accepted 10 January, 2019 Supplemental digital content is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML text of this article on the journal's Web site (www.jpgn.org). Financial disclosure: The authors have no financial relationships relevant to this article to disclose. Funding source: No external funding for this manuscript. Potential conflicts of interest: The authors have no conflicts of interest relevant to this article to disclose. © 2019 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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