The impact of anti-secretory drugs on pediatric GERD: efficacy and insights: a narrative review

Gastroesophageal reflux (GER) is a normal physiological phenomenon that occurs in infant which is resolving mostly by the age of one year. GER becomes gastroesophageal reflux disease (GERD) when symptoms become troublesome or complications arise, such as feeding difficulties or failure to thrive. The diagnosis and treatment of pediatric GERD is complicated by variability in clinical presentations with absence of definitive evidence-based guidelines in the published literature. This narrative review addresses a range of pharmacologic treatment options, proton pump inhibitors and H2 receptor antagonists respectively, and, analyzes them in terms of efficacy and safety. The review highlights the importance of evidence-based practice and individualized solutions to improve patient care and the roles of standardized guidelines. The review also describes gaps in our current knowledge and suggests future research on ways to improve treatment options for children with GERD. Acid-suppressing therapies are widely used in managing pediatric GERD despite limited long-term safety data. Proton pump inhibitors are more effective than H2 receptor antagonists for symptom control in older children. Ranitidine, once widely used, is now withdrawn due to safety concerns and carcinogenic risk. Prokinetic agents and antacids are limited by side effects and lack of robust pediatric efficacy data. Standardized treatment guidelines for pediatric GERD remain lacking, necessitating further research.