Yuda Satrio Wicaksono
Gastrohepatology Division, Department of Child Health, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia

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Pediatric Gastroesophageal Reflux Disease (GERD): A Literature Review Farahdina Shahnaz; Yuda Satrio Wicaksono; Himawan Aulia Rahman
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 2 No. 2 (2023): APGHN Vol. 2 No. 2 May 2023
Publisher : The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58427/apghn.2.2.2023.46-60

Abstract

Background: Gastroesophageal reflux disease (GERD) is a condition where stomach contents reflux into the esophagus, causing discomfort and complications. It is most prevalent in infants (26.9%) and lesser in children under 10 (3.2%) and over 10 years old (10.1%). Discussion: GERD is caused by frequent relaxations of the lower esophageal sphincter (LES), allowing stomach contents to escape into the esophagus. Symptoms vary with age, with infants experiencing regurgitation and irritability, while older children may have heartburn and nausea. Diagnosis requires differentiating GERD from similar conditions and may involve various tests, though their primary use lacks sufficient evidence. Nonpharmacological treatments include thickened feeding, reducing feeding volume but increasing frequency and possibly eliminating cow's milk protein. Pharmacological treatments include Proton Pump Inhibitors (PPIs), and Histamine Receptor Antagonists (H2RAs), though their efficacy varies. Prokinetics are generally not recommended due to lack of evidence. If all these treatments fail, anti-reflux surgery such as fundoplication can be considered. Conclusion: The hallmark of GERD is the presence of esophagitis during endoscopy. However, Barrett’s esophagus is rare in pediatric GERD patients. Factors indicating a worse prognosis include early onset age, an initial GERD diagnosis, and the need for PPI or combination of H2RA and PPI treatment.
Pediatric Nutritional Assessment Helisa Rachel Patrice Sianipar; Jully Neily Kasie; Yuda Satrio Wicaksono
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 2 No. 4 (2023): APGHN Vol. 2 No. 4 November 2023
Publisher : The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58427/apghn.2.4.2023.36-46

Abstract

Background: Pediatric nutrition plays a vital role in the growth and development of children. It not only meets the daily nutritional needs of healthy children but also supports their normal growth. In contrast, for unhealthy children, it aims to prevent growth delays and developmental issues, especially in cognitive functions. The situation in Indonesia presents a unique challenge with the coexistence of undernutrition and overnutrition, both having significant short-term and long-term health impacts. Discussion: In the realm of pediatric nutrition, malnutrition manifests in various forms. Nutritional deficiencies such as wasting, stunting, and being underweight arise from inadequate dietary intake. Additionally, there are concerns about micronutrient malnutrition, which includes both deficiencies and excesses of vital nutrients. Overnutrition, leading to obesity and associated chronic diseases, is also a significant problem. The approach to pediatric nutritional care is multi-faceted, involving the assessment of nutritional status, determination of individual caloric needs, and selecting the appropriate method for nutrition delivery, whether it be oral, enteral, or parenteral. Monitoring and evaluating the effectiveness of these interventions is a critical ongoing process. An important aspect of preventive care includes educating parents about proper feeding techniques, such as establishing regular meal times and understanding the child's hunger and satiety signals, to avoid feeding difficulties. For cases like Failure to Thrive (FTT), where children do not meet standard growth metrics, careful management is necessary to ensure adequate nutrition and to prevent complications like refeeding syndrome. Conclusion: Effective pediatric nutrition requires a holistic and personalized approach. It is crucial in addressing the dual burden of undernutrition and overnutrition in Indonesia. By implementing proper nutritional care and structured feeding practices, children's health outcomes can be significantly improved, supporting their growth and developmental processes.