Rossor T, et al. - This study reviewed the investigation and management of gastro-oesophageal reflux (GOR) in United Kingdom neonatal intensive care units. Accumulated data displayed a wide variation in diagnostic and treatment strategies for infants with suspected GOR on neonatal intensive care units. These findings highlighted the requirement for randomised trials to assess appropriate GOR management.

Methods

• A questionnaire was sent to all 207 UK neonatal units.

Results

• From 84% of units, responses were obtained.
• The most frequent “investigation” was a trial of therapy (83% of units); pH studies were used in 38%, upper GI contrast studies in 19% and multichannel intraluminal impedance (MII)/pH studies in 5%.
• Only six units suggested a threshold for an abnormal pH study and two units for an abnormal MII study.
•  Infants were commenced on anti-reflux medication without investigation always in 32% of units, often in 29%, occasionally in 19% and only never in 1%.
• In 60% of units gaviscon was used as first line treatment, other medications included ranitidine in 53%, thickening agents in 27%, proton pump inhibitors in 23%, domperidone in 22% and erythromycin in 6%.