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Elgg / Städtchen und Umgebung, Switzerland

Grillhosl C.,Universitatsklinikums Erlangen und Kinderklinik | Frohlich T.,Universitatsklinikums Erlangen und Kinderklinik | Kohler H.,Universitatsklinikums Erlangen und Kinderklinik | Kohler H.,Kantonsspital Aarau AG
Padiatrische Praxis | Year: 2011

Gastroesophageal reflux (GER) is very common in children and in many cases a physiological event. However, if GER results in symptoms or pathological findings such as oesophagitis, it is called gastroesophageal reflux disease (GERD). Besides anatomical reasons there are certain nutritional factors favouring a pathological gastroesophageal reflux in children. Furthermore during the last years an increasing incidence of diseases similar in symptoms, but with an assumed allergic pathogenesis has been described. In eosinophilic esophagitis (EoE) corticosteroid therapy leads only to a temporary improvement. In contrast allergen elimination results in a complete disappearance of symptoms and histopathological findings in almost all patients. It is possible to try an identification of a relevant food antigen by skin prick and patch tests and the determination of specific IgE, but often this is not successful. By the elimination of the six most common food antigens (milk, egg, wheat, soy, peanuts and fish) it is possible to improve symptoms in three-quarters of patients. Using allergen-free formula food, the success rates are rising up to 98%. A particular entity is the cow's milk protein allergy of infancy. There is a clear association with gastroesophageal reflux disease and due to the often completely non-specific symptoms in this age group the diagnosis is not always easy. Under cow's milk protein-free formula-food, most of the affected children show a very good response. In contrast to EoE the majority of infants with cow's milk protein allergy are expected to develop tolerance within the first few years of life. Source


Grillhosl C.,Universitatsklinikums Erlangen und Kinderklinik | Frohlich T.,Universitatsklinikums Erlangen und Kinderklinik | Kohler H.,Universitatsklinikums Erlangen und Kinderklinik
Internistische Praxis | Year: 2012

Gastroesophageal reflux (GER) is very common in children and in many cases a physiological event. However, if GER results in symptoms or pathological findings such as esophagitis, it is called gastroesophageal reflux disease (GERD). Besides anatomical reasons there are certain nutritional factors favouring a pathological gastroesophageal reflux in children. Furthermore during the last years an increasing incidence of diseases similar in symptoms, but with an assumed allergic pathogenesis has been described. In eosinophilic esophagitis (EoE) corticosteroid therapy leads only to a temporary improvement. In contrast allergen elimination results in a complete disappearance of symptoms and histopathological findings in almost all patients. It is possible to try an identification of a relevant food antigen by skin prick and patch tests and the determination of specific IgE, but often this is not successful. By the elimination of the six most common food antigens (milk, egg, wheat, soy, peanuts and fish) it is possible to improve symptoms in three-quarters of patients. Using allergen-free formula food, the success rates are rising up to 98%. A particular entity is the cow's milk protein allergy of infancy. There is a clear association with gastroesophageal reflux disease and due to the often completely non-specific symptoms in this age group the diagnosis is not always easy. Under cow's milk protein-free formula-food, most of the affected children show a very good response. In contrast to EoE the majority of infants with cow's milk protein allergy are expected to develop tolerance within the first few years of life. Source

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