Gastroesophageal reflux disease as a cause for emesis in infants.

Vomiting is a very common symptom associated with gastroesophageal reflux disease (GERD) in infancy, although no longer the most common symptom seen in infants with GERD. A thorough evaluation of these patients with clinical history, physical examination, and sophisticated diagnostic procedures is necessary to identify that the vomiting is from GERD. Extended esophageal pH monitoring is the most reliable diagnostic procedure used to confirm the presence or absence of GERD, and provides additional information regarding prognosis and the relationship of the GERD to respiratory complaints. The latter information allows the clinician to determine the optimal type of antireflux therapy offered to the vomiting infant with GERD. Reevaluation of the vomiting infant with suspected recurrent GERD after antireflux operation should not differ from the evaluation performed in an untreated infant with vomiting from suspected GERD.