Objective: To develop a North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) international consensus on the diagnosis and management of gastroesophageal reflux and gastroesophageal reflux disease in the pediatric population.
Methods: An international panel of 9 pediatric gastroenterologists and 2 epidemiologists were selected by both societies, which developed these guidelines based on the Delphi principle. Statements were based on systematic literature searches using the best-available evidence from PubMed, Cumulative Index to Nursing and Allied Health Literature, and bibliographies. The committee convened in face-to-face meetings 3 times. Consensus was achieved for all recommendations through nominal group technique, a structured, quantitative method. Articles were evaluated using the Oxford Centre for Evidence-based Medicine Levels of Evidence. Using the Oxford Grades of Recommendation, the quality of evidence of each of the recommendations made by the committee was determined and is summarized in appendices.
Results: More than 600 articles were reviewed for this work. The document provides evidence-based guidelines for the diagnosis and management of gastroesophageal reflux and gastroesophageal reflux disease in the pediatric population.
Conclusions: This document is intended to be used in daily practice for the development of future clinical practice guidelines and as a basis for clinical trials.
*UZ Brussel Kinderen, Brussels, Belgium
†Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI, USA
‡Division of Pediatric Gastroenterology, Nationwide Children's Hospital, The Ohio State University, Columbus, OH, USA
§Division of Gastroenterology, Department of Pediatrics, British Columbia Children's Hospital/University of British Columbia, Vancouver, BC, Canada
||Department of Pediatrics, Upstate Medical University, Syracuse, NY, USA
¶Department of Pediatrics, University of Texas Health Sciences Center Houston and Shriners Hospital for Children, Houston, TX, USA
#Department of Pediatrics, University of Colorado Health Sciences Center, Denver, CO, USA
**Department of Pediatrics, University of Naples “Federico II,” Naples, Italy
††Centre for Paediatric Gastroenterology, Sheffield Children's Hospital, Western Bank, Sheffield, UK
‡‡Pediatric Gastroenterology & Nutrition, Queen Paola Children's Hospital-ZNA, Antwerp, Belgium
§§Klinik für Kinder- und Jugendmedizin, Universitätsklinikum der RWTH Aachen, Aachen, Germany
Received 27 May, 2009
Accepted 31 May, 2009
Address correspondence and reprint requests to Colin D. Rudolph, MD, PhD, Professor of Pediatrics & Vice Chair for Clinical Affairs, Chief, Pediatric Gastroenterology, Hepatology, and Nutrition, Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Wisconsin, Medical College of Wisconsin, 9000 W Wisconsin Ave, Milwaukee, WI 53226 (e-mail: email@example.com).
Carlo Di Lorenzo, Eric Hassall, Gregory Liptak, Lynnette Mazur, Judith Sondheimer, Annamaria Staiano, Michael Thomson, Gigi Veereman-Wauters, and Tobias G. Wenzl contributed equally to the development of these guidelines. Abstract adapted by Gregory Liptak.
Authors' disclosures are listed in Appendix D.