India, Oct. 12 -- Gastrooesophageal reflux (GER) is a common, often harmless condition where stomach contents flow back up into the oesophagus or food pipe. This causes spitting up and regurgitation - when milk or food returns to the throat or mouth. GER happens in babies because the ring-shaped muscle, at the bottom of the oesophagus, the lower oesophageal sphincter (LES) is not fully developed. In some babies, the LES relaxes too often or doesn't close properly, thus allowing milk, formula, and acid from the stomach to flow back up into the oesophagus. This reflux can cause irritation and discomfort, and sometimes result in vomiting as well. GER is common in babies in the first two years of life. Gastroesophageal reflux disease (GERD) is a chronic and more severe form of reflux, where stomach contents flow back into the oesophagus, leading to discomfort that can potentially lead to complications. Unlike GER, GERD is more severe and long-lasting, often causing troublesome symptoms such as heartburn, chronic cough, feeding difficulties and poor weight gain. In a study from India, about three out of 10 children (31.6%) with reflux-like complaints had GERD. Most cases were mild to moderate in intensity but the prevalence was highest in infants under one year and dropped to about 20% by age two (1). GER doesn't typically result in medical complications. In fact, in majority of cases, infants outgrow this condition by 12 to 14 months of age. Unlike GER, GERD is more severe and long-lasting, often causing troublesome symptoms such as heartburn, chronic cough, feeding difficulties, generalised irritability, excessive crying, poor sleep, and poor weight gain. Being overweight or having obesity can increase the chance of developing GERD. Medicines for GERD should not be the first step of treatment in infants or children. A majority of babies with reflux improve with simple changes. For many infants, symptoms naturally improve by the end of the first year of life. Pharmacological treatment should be considered only when symptoms are severe, persistent, or leading to complications despite appropriate non-pharmacological measures. When drug therapy is required, proton pump inhibitors are the first choice as they are most effective in healing oesophagitis (inflammation of the oesophagus) and controlling acid symptoms. H2 receptor antagonists may be used if PPIs cannot be given, but other medications such as prokinetics, alginates, or antacids are not recommended for children because of limited proven benefits and potential safety concerns. Even when medicines are given, the goal is usually a limited course rather than indefinite treatment, and reassessment is needed to confirm that symptoms improve with therapy. Reference: 1. Kesavelu D, Turk Arch Pediatr. 2025 Dr Sibal is a leading Pediatric Gastroenterologist and Hepatologist with over three decades of experience and five books to his credit, including "Is Your Child Ready to face the World"?...