Natural course of gastroesophageal reflux disease during infancy - six-month follow-up

Background Very few data have been published about the natural course of gastro-esophageal reflux (GER) symptoms during infancy; further, no risk factors of GER disease (GERD) have been identified. Objectives To determine the prevalence and natural course of regurgitation in infancy and factors of gastroesophageal reflux disease. Methods A cohort of 223 healthy infants who attended Integrated Health Services run by local housewife (Posyandu) of Ciputat suburb of Jakarta - between March and November 2005. Information on subjects' history of regurgitation and other refluxrelated symptoms was obtained by interviewing mother and diary record. Subjects were followed up to age of 1 year irrespective of the clinical status. Results At 6 months of age most infants (56.5%) had regurgitation 1 to 3 days per week and only 2.7% infants regurgitated daily. Regurgitation 1 to 3 episodes per day was found in 92.8% of subjects. The proportion of infants regurgitation decreased gradually with age; the proportion for the consecutive 6 to 11 month was 100%, 65.5%, 33.6%, 14.3%, 3.6% and 1.3%, respectively. At the age of 1 year no infants was found to be regurgitated. Related symptoms included hiccup (58.3%), vomiting (23.3%) and back arching (2.2%). Feeding problem occurred in 34.1% infants and occurred more likely in infants who regurgitate daily compared to 4 - 6 day per week (OR 3.5; 95%CI 2.2;5.6) and 1 - 3 day per week (OR 1.8; 95%CI 0.6;0.9). Conclusions Regurgitation in infancy disappears spontaneously with age. Reflux-related symptoms are hiccup, vomiting and back arching. Feeding problem occurs most likely in infants who regurgitate daily.