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The Degree of GERD, by Dr. Suzanne P. Nelson

Taken from http://www.medicalcrossfire.com/debate_archive/2002/Oct02/GERD.htm

Gastroesophageal reflux is common in children. More than 60% of infants at four months of age regurgitate at least once a day; in infants, the primary manifestation of reflux is regurgitation. As children become older, 5% to 10% complain of acid reflux symptoms on at least a weekly basis; these symptoms include not only regurgitation but also chest pain and other symptoms similar to those seen in adults. Pediatricians generally try to distinguish between gastroesophageal reflux and gastroesophageal reflux disease (GERD). We consider that a child has GERD when he demonstrates some complication of reflux, for example, poor growth, feeding problems, pain, anemia, and extraintestinal manifestations such as cough, chronic laryngitis, or asthma. See Full Article

Refereed journal articles:

    1. McLone DG, Suwa J, Collins JA, Poznanski SC*, Knepper PA. Neuralization: Biochemical and morphological studies on primary and secondary neural tube defects. Concepts in Pediatric Neurosurgery 4:15-19, 1983.

    2. Werbel GB, Nelson SP, Robinson PG, Anastasi J, Joehl RJ, Rege RV. A foregut carcinoid tumor causing Zollinger-Ellison syndrome. Archives of Surgery 124:381-384, 1989.

    3. Nelson SP, Jonas M. Hepatitis C infection in children who received extracorporeal membrane oxygenation. Journal of Pediatric Surgery 31:644-648, 1996.

    4. Nelson SP, Chen EH, Syniar GM, Kaufer Christoffel K. Prevalence of symptoms of gastroesophageal reflux during infancy: a pediatric practice-based survey. Archives of Pediatrics and Adolescent Medicine 151:569-572, 1997.

    5. Badizadegan K, Jonas MM, Ott MJ, Nelson SP, Perez-Atayde AR. Histopathology of the liver in children with chronic hepatitis C viral infection. Hepatology 28(5):1416-23.

    6. Jonas M, Ott MJ, Nelson SP, Badizadegan K, Perez-Atayde AR. Interferon-alpha treatment of chronic hepatitis C virus infection in children. The Pediatric Infectious Disease Journal 17:241-246, 1998.

    7. Nelson SP, Lin PL, Miller J, Katz B, Gonzalez-Crussi F. Cryptosporidia enterocolitis in an immunocompetent infant treated with paromomycin. Clinical Pediatrics 38:367-369, 1999.

    8. Nelson SP, Chen EH, Syniar GM, Kaufer Christoffel K. One year follow-up of symptoms of gastroesophageal reflux during infancy. Pediatrics electronic pages 102:1470-1471, 1998.

    9. Nelson SP, Chen EH, Syniar GM, Kaufer Christoffel K. Prevalence of symptoms of gastroesophageal reflux during childhood: a pediatric practice-based survey. Archives of Pediatrics and Adolescent Medicine. 154:150-154, 2000

    10. Kumar R, Sentongo T, Nelson SP, Melin-Aldana H, Li B UK. Eosinophillic esophagitis in children. A review. Clinical and Applied Immunology Reviews 4:173-188, 2003.

    11. Kohr LP, Dargan M, Hague A, Nelson SP, Duffy EC, Mavroudis C, Backer CL. The Incidence of Swallowing Dysfunction in Pediatric Patients Following Open Heart Surgery. Annuals of Thoracic Surgery 76(5):1450-6, 2003.

    12. Sundaram S, Sunku B, Nelson SP, Sentongo T, Melin-Aldana H, Kumar R, Li B UK. Adherent white plaques: A novel endoscopic finding in eosinophilic esophagitis. J Pediatr Gastroenterol Nutr 38(2):208-212, 2004.

    13. Kleinman L, Rothman M, Strauss R, Orenstein SR, Nelson S, Vandenplas Y, Cucchiara S, Revicki, DA. The Infant Gastroesophageal Reflux Questionnaire Revised: Development and Validation as a Evaluative Instrument. Clinic Gastroenterol Hepatol 4:588-596, 2006.

    14. Kagalwalla AF, Sentongo TA, Ritz S, Hess T, Nelson SP, Emerick KM, Melin-Aldana H, Li BU. The effect of six-food elimination diet on clincial and histolgic outcomes in eosinophillic esophagitis. Clinical Gastroenterology and Hepatology 4:1097-102, 2006.

    15. Li BU, Lefevre F, Chemlimsky GG, Boles RG, Nelson SP, Lewis DW, Linder SL, Issenman RM, Rudolph CD. North America Society for Pediatric Gastroenterology, Hepatology and Nutrition consensus statement on the diagnosis and management of cyclic vomiting syndrome. Journal of Pediatric Gastroenterology and Nutrition 47(3):379-93, 2008.

Abstracts:

    1. Poznanski S*, King K. The effects of prenatal alcohol exposure on brain morphology, histology and open-field behavior in rats. November 6-11, 1983. Society of Neuroscience, Boston, MA.

    2. Poznanski S*, McLone DG, Lubeck D, Beauchamp G, Knepper PA. Primary aphakia in the SP/SP mouse. April 30 - May 4, 1984, The Association for Research in Vision and Ophthalmology, Sarasota, FL.

    3. Nelson SP and Jonas MM. Cirrhosis in children with chronic hepatitis C. November 5-6, 1993, North American Society for Pediatric Gastroenterology and Nutrition, Chicago, IL.

    4. Nelson SP and Jonas MM. HCV infection in children and supported with extracorporeal membrane oxygenation (ECMO) in the neonatal period. November 5-6, 1993, North American Society for Pediatric Gastroenterology and Nutrition, Chicago, IL.

    5. Jonas MM, Nelson SP and Ott MJ. Interferon-alfa therapy of chronic hepatitis C virus infection in children. November 3-7, 1995. American Association for the Study of Liver Diseases, Chicago, IL.

    6. Nelson SP, Chen EH, Syniar G, Kaufer-Christoffel K, and the Pediatric Practice Research Group. Symptoms of gastroesophageal reflux during infancy: A pediatric practice-based survey. May 19-22, 1996, Digestive Disease Week, San Francisco, CA.

    7. Nelson SP, Chen EH, Syniar G, Kaufer-Christoffel K, and the Pediatric Practice Research Group. Symptoms of gastroesophageal reflux during childhood: A pediatric practice-based survey. May 11-14, 1997, Digestive Disease Week, Washington, DC.

    8. Nelson SP, Chen EH, Stanton K, Kaufer-Christoffel K, and the Pediatric Practice Research Group. Symptoms of gastroesophageal reflux during infancy: 2.5 year follow-up. October 21-24, 1999, North American Society for Pediatric Gastroenterology and Nutrition, Denver, CO.

    9. Nelson SP, Berry, CA, Mattson, CL, Rubba, CR. Parental stress in a pediatric gastroenterologist's practice. May 21-24, 2000, Digestive Disease Week, San Diego, CA.

    10. Kohr LP, Dargan M, Hague A, Nelson SP, Duffy EC, Mavroudis C, Backer CL. The Incidence of Swallowing Dysfunction in Pediatric Patients Following Open Heart Surgery. November 12-15, 2000, American Heart Association, New Orleans, LA.

    11. Nelson SP, Berry, CA, Ruch-Ross, H., Folan, M., Caron, A., Han, S., Mattson, CL, Apostol, K. The Efficacy of Ginger in the Treatment of Uncomplicated Gastroesophageal Reflux in Infants: A Randomized Double-Blind Placebo-Controlled Trial. NASPGHAN, Orlando, 2001

    12. Melin-Aldana H, Stoltenberg AM, Zapata, JF, Chou PM, Nelson SP. Association of IgG and IgA Anti-Gliadin Positivity and TTG Negativity, with Gastrointestinal Inflammation Other Than Celiac Disease in Children. Society for Pediatric Pathology, Washington DC, 2003.

    13. Kagalwalla AF, Stoltenberg AM, Li BU, Amoruso L, Nelson SP. Measuring the Health Related Quality of Life in Children with Eosinophilic Esophagitis. J Pediatr Gastro Nutr. 2003; 37 (3):354.

    14. Nelson SP, Weissert J, Sinacore JM, Sentongo TA, Stoltenberg AM, Li BU. Development of a Questionnaire to Measure Symptoms in Children with Functional Gastrointestinal Disorders. J Pediatr Gastro Nutr. 2003; 37 (3):358.

    15. Nelson SP, Melin-Aldana H, Stoltenberg AM, Sunku BK, Weissert J, Li, BU. The Natural History of Non-Specific Colitis and Focal Inflammation in Children. J Pediatr Gastro Nutr. 2003; 37 (3):376.

    16. Stoltenberg AM, Melin-Aldana H, Li BUK, Kagalwalla AF, Sentongo TA, Nelson SP. Gastroesophageal Reflux Symptoms and Quality of Life Do Not Correlate with Esophageal Histopathology in Children with Eosinophillic Esophagitis. 2nd World Congress of Pediatric Gastroenterology, Hepatology & Nutrition, Paris, France, July 2004.

    17. Nelson SP, Kothari S, Wu EQ, Persson B, Beaulieu N, Arana M, Lu M. Healthcare Utilization and Cost in Pediatric Gastroesophageal Reflux Disease (GERD) Patients on Continuous v. Intermittent Proton Pump Inhibitor (PPI) Treatment Regimens. ACG, Philadelphia 2007.

    18. Nelson SP, Orenstein SR, El-Serag H, Kothari S, Wu EQ, Persson B, Beaulieu N, Arana M. Differences in Health Care Visits Coded for Potential Proxy Conditions/Symptoms of Gastroesophageal Reflux Disease (GERD) Before and After a GERD Diagnosis: A Pediatric Database Study. ACG, Philadelphia 2007.

    19. Nelson SP, Wu E, Kothari S, Yang E, Atanasov, BA. Health Care Costs in Pediatric Patients Diagnosed with GERD or Acid Related Conditions (GERD/ARC) -- A Comparison Between H2RA vs PPIs. NASPGHN, Salt Lake City, 2007.

    20. Nelson SP, Mulvhill E, Kothari S. Prevalence of GERD and GERD Symptoms in Children: An Internet Survey. NASPGHN, Salt Lake City, 2007.

    21. Nelson SP, Wu E, Kothari S, Yang E, Atanasov P. Pattern of Care in Pediatric Patients Diagnosed with GERD or Acid Related Conditions (GERD/ARC). NASPGHN, Salt Lake City, 2007.

    22. Marcus SB, Strople Ja, Neighbors, Weissberg-Benchell, Nelson SP, Varni JW, Alonso EM. Fatigue and health related quality of life (HRQOL) in pediatric inflammatory bowel disease (IBD). DDW, San Diego, 2008.

    23. Nelson SP, Roberts L, Kothari S, Orenstein SR, Gold BD, Hassall E, Mody R, Kleinman L, Dabbous OH. Validation of the pediatric gastroesophageal reflux disease symptom and quality of life questionnaire (PGSQ). ACG, Orlando, 2008.

    24. Shah AM, Kagalwalla AF, Melin Aldana H, Sentongo TS, Nelson SP, Hess T, Li BU K. Indentification of specific food antigen(s) causing eosinophilic esophagitis in children treated with six food elimination diet. NASPGHN, San Diego, 2008.



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