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Prevalence of Gastroesophageal Reflux Disease Symptoms in Infants and Children

A Systematic Review

Singendonk, Maartje*; Goudswaard, Eline*; Langendam, Miranda; van Wijk, Michiel*,‡; van Etten-Jamaludin, Faridi*; Benninga, Marc*; Tabbers, Merit*

Journal of Pediatric Gastroenterology and Nutrition: June 2019 - Volume 68 - Issue 6 - p 811–817
doi: 10.1097/MPG.0000000000002280
Original Articles: Gastroenterology

Objectives: Gastroesophageal reflux disease (GERD) is defined as gastroesophageal reflux 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 to 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 487,969 children. In infants (0–18 months), GERD symptoms are present in more than a quarter of infants on a daily basis and show a steady decline in frequency with almost complete disappearance of symptoms at the age of 12 months. In children older than 18 months, GERD symptoms show large variation in prevalence between studies (range 0%-38% of study population) and overall, are present in >10% and in 25% on respectively a weekly and monthly basis. Of the risk factors assessed, higher body mass index 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.

*Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital/Amsterdam UMC

Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC/University of Amsterdam

Department of Pediatric Gastroenterology, Amsterdam UMC, Amsterdam, The Netherlands.

Address correspondence and reprint requests to Maartje Singendonk, MD, PhD, Emma Children's Hospital/Amsterdam UMC – location AMC, C2-312, PO Box 22700, 1100 DD Amsterdam, The Netherlands (e-mail:

Received 29 October, 2018

Accepted 10 January, 2019

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The authors report no conflicts of interest.

© 2019 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,