Gastroesophageal reflux disease (GERD) diagnosis and treatment options for children with neurologic impairment (NI) have been debated for >3 decades. GERD has an undoubted impact on children with NI; however, it is difficult to differentiate GERD from other common gastrointestinal diseases in this population, and there is no robust evidence distinguishing the various management options. In response to these challenges, the 2017 European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines formalized recommendations surrounding common diagnostic considerations and treatments for GERD in children with NI. Recommendations include initial treatment with a proton pump inhibitor, the consideration of formula and feeding changes, and pursuing diagnostic testing to gain objective data and rule out other causes of persistent symptoms. Gastrojejunal tube (GJT) feeding is suggested when GERD is causing aspiration, in addition to when there is recurrent vomiting or gastroparesis. Fundoplication and total esophagogastric disconnection are to be reserved for...

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