Comparative Analysis of Pharmacological Treatments and Lifestyle Modifications for Managing Gastroesophageal Reflux Disease in Infants: A Literature Review.

Abstract

Gastroesophageal reflux disease (GERD) is a common condition in infants, causing vomiting, irritability, and feeding difficulties. Though typically mild and self-limiting, severe cases may result in complications such as esophagitis, failure to thrive, or recurrent aspiration pneumonia. This review highlights a tiered approach to management, emphasizing non-pharmacological methods such as feeding adjustments, and thickened feeds as first-line treatments. These strategies are effective for mild to moderate cases, reducing unnecessary medication risks. Pharmacologic interventions, primarily proton pump inhibitors and histamine-2 receptor antagonists, are reserved for severe cases, such as erosive esophagitis or persistent respiratory symptoms, where non-pharmacological approaches have failed. While medications promote mucosal healing, their efficacy for symptoms like irritability or vomiting in non-severe cases is mixed, raising concerns about overuse. Adverse effects include increased infection risks, gut microbiota changes, and nutrient malabsorption. Future research should refine diagnostic criteria and develop evidence-based guidelines to prevent overtreatment.