Optimization of Diagnosis and Treatment Strategies for Vomiting Syndrome in Infants

Abstract

The aim of this study is to analyze current approaches to the diagnosis and management of gastroesophageal reflux (GER) and gastroesophageal reflux disease (GERD) in infants during the first year of life. The paper presents data from Russian and international studies addressing the prevalence and structure of risk factors, including perinatal pathology, intrauterine infections, and birth trauma as contributors to gastrointestinal dysfunction. Particular attention is given to the clinical features of congenital hypertrophic pyloric stenosis, persistent regurgitation syndrome, and their differentiation from other congenital or functional gastrointestinal disorders. Diagnostic modalities discussed include esophagogastroduodenoscopy, radiological imaging, 24-hour pH monitoring, scintigraphy, and esophageal manometry. The European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN, 2005) guidelines are reviewed, emphasizing a stepwise treatment strategy: parental counseling and psychological support, postural therapy, and dietary interventions with specialized anti-reflux formulas. In cases of treatment resistance, pharmacological therapy with prokinetics or acid-suppressive drugs is recommended, while surgical correction using fundoplication remains the method of choice in severe and complicated cases. The paper highlights findings from clinical trials indicating that GERD symptoms may resolve, but histological esophagitis often persists, increasing the risk of complications such as strictures, Barrett’s esophagus, and even adenocarcinoma. The conclusion stresses the importance of raising awareness among primary care pediatricians, ensuring timely diagnosis, implementing international treatment standards, and providing long-term follow-up for infants at risk of complicated GERD.