{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T12:34:54Z","timestamp":1789562094438,"version":"build-2803163510"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T00:00:00Z","timestamp":1715558400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Gastroesophageal reflux (GER) disease (GERD) is a condition wherein GER causes troublesome symptoms that can affect daily functioning and\/or clinical complications within the esophagus or other systems. To avoid this, patients with GERD often require treatment; hence, it is important to distinguish GER from GERD. Patients with GERD exhibiting alarm signs should be examined early to differentiate it from GER and treated accordingly. Herein, we present a case of GERD caused by a hiatal hernia that required surgical intervention for esophagial cicatrical stenosis despite oral treatment. We also discussed how to choose the appropriate acid suppressants for GERD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>A 1-year-old boy was referred to our hospital for repeated vomiting and poor weight gain. He received histamine 2 receptor antagonists (H2RAs) that contributed slightly to the decreased frequency of vomiting and aided weight gain; however, he soon stopped gaining weight and had bloody vomit. His upper gastrointestinal series revealed hiatal hernia, a 24\u2005h impedance pH monitoring test indicated abnormal values for acid reflux, and esophagogastroduodenoscopy (EGD) revealed esophagitis. He was subsequently diagnosed with GERD associated with hiatal hernia. A proton pump inhibitor (PPI) was intravenously administered to him, following which his medication was changed to a potassium-competitive acid blocker (P-CAB). Thereafter, his vomiting episodes significantly decreased and his weight increased. However, 6 months after starting P-CAB, his vomiting episodes suddenly increased in frequency. EGD revealed the presence esophageal stricture due to scarring from GERD. He was then treated via laparoscopic fundoplication, gastrostomy, and esophageal balloon dilation. Thereafter, his vomiting episodes stopped and food intake improved, leading to weight gain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>It is essential to identify the cause of GERD early and take an appropriate treatment approach depending on the cause of GERD with alarm signs. Further, as a drug therapy for GERD as a clear acid mediated disease or in children with alarm signs, PPIs or P-CAB should be used from the beginning instead of H2RAs.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2024.1305585","type":"journal-article","created":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T04:47:32Z","timestamp":1715575652000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Case Report: The importance of early intervention for gastroesophageal reflex disease caused by hiatal hernia"],"prefix":"10.3389","volume":"12","author":[{"given":"Toshihiko","family":"Kakiuchi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Obata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azusa","family":"Koji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuya","family":"Minematsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maho","family":"Fuchigami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsuhisa","family":"Fukuta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuro","family":"Tajiri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masato","family":"Yoshiura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,5,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"516","DOI":"10.1097\/mpg.0000000000001889","article-title":"Pediatric gastroesophageal reflux clinical practice guidelines: joint recommendations of the North American society for pediatric gastroenterology, hepatology, and nutrition and the European society for pediatric gastroenterology, hepatology, and nutrition","volume":"66","author":"Rosen","year":"2018","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1189","DOI":"10.1111\/j.1651-2227.2009.01306.x","article-title":"Natural evolution of regurgitation in healthy infants","volume":"98","author":"Hegar","year":"2009","journal-title":"Acta Paediatr"},{"key":"B3","doi-asserted-by":"publisher","first-page":"84","DOI":"10.4253\/wjge.v15.i3.84","article-title":"Gastroesophageal reflux disease in children: what\u2019s new right now?","volume":"15","author":"Sintusek","year":"2023","journal-title":"World J Gastrointest Endosc"},{"key":"B4","first-page":"187","article-title":"GER and GERD in children: to treat or not to treat?","volume":"67","author":"Quitadamo","year":"2015","journal-title":"Minerva Pediatr"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1671","DOI":"10.3390\/ijms18081671","article-title":"Gastro-esophageal reflux in children","volume":"18","author":"Rybak","year":"2017","journal-title":"Int J Mol Sci"},{"key":"B6","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1111\/apa.17074","article-title":"Infant gastroesophageal reflux disease management consensus","volume":"113","author":"Vandenplas","year":"2024","journal-title":"Acta Paediatr"},{"key":"B7","doi-asserted-by":"publisher","first-page":"761631","DOI":"10.3389\/fnut.2021.761631","article-title":"Ghrelin enhancer, the latest evidence of Rikkunshito","volume":"8","author":"Yamada","year":"2021","journal-title":"Front Nutr"},{"key":"B8","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1007\/s00423-010-0637-y","article-title":"Laparoscopic toupet fundoplication","volume":"395","author":"Wenck","year":"2010","journal-title":"Langenbecks Arch Surg"},{"key":"B9","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1080\/20469047.2018.1489649","article-title":"Gastroesophageal reflux disease (GERD) in children","volume":"39","author":"Poddar","year":"2019","journal-title":"Paediatr Int Child Health"},{"key":"B10","doi-asserted-by":"publisher","first-page":"e1684","DOI":"10.1542\/peds.2013-0421","article-title":"Gastroesophageal reflux: management guidance for the pediatrician","volume":"131","author":"Lightdale","year":"2013","journal-title":"Pediatrics"},{"key":"B11","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1016\/j.pcl.2018.12.012","article-title":"Gastroesophageal reflux disease in the neonatal intensive care unit infant: who needs to be treated and what approach is beneficial?","volume":"66","author":"Gulati","year":"2019","journal-title":"Pediatr Clin North Am"},{"key":"B12","doi-asserted-by":"publisher","first-page":"719","DOI":"10.1111\/j.1365-2036.2004.02149.x","article-title":"The role of the hiatus hernia in gastro-oesophageal reflux disease","volume":"20","author":"Gordon","year":"2004","journal-title":"Aliment Pharmacol Ther"},{"key":"B13","doi-asserted-by":"publisher","first-page":"2685","DOI":"10.1111\/j.1572-0241.2006.00828.x","article-title":"Esophageal stricture: incidence, treatment patterns, and recurrence rate","volume":"101","author":"Ruig\u00f3mez","year":"2006","journal-title":"Am J Gastroenterol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1197","DOI":"10.1097\/CCM.0b013e3181d69ccf","article-title":"The efficacy and safety of proton pump inhibitors vs. histamine-2 receptor antagonists for stress ulcer bleeding prophylaxis among critical care patients: a meta-analysis","volume":"38","author":"Lin","year":"2010","journal-title":"Crit Care Med"},{"key":"B15","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1093\/intqhc\/mzaa041","article-title":"Meta-analysis of proton pump inhibitors induced risk of community-acquired pneumonia","volume":"32","author":"Nguyen","year":"2020","journal-title":"Int J Qual Health Care"},{"key":"B16","doi-asserted-by":"publisher","first-page":"e0168618","DOI":"10.1371\/journal.pone.0168618","article-title":"Use of proton pump inhibitors and the risk of hospitalization for infectious gastroenteritis","volume":"11","author":"Chen","year":"2016","journal-title":"PLoS One"},{"key":"B17","doi-asserted-by":"publisher","first-page":"57","DOI":"10.4292\/wjgpt.v5.i2.57","article-title":"Histamine2-receptor antagonists: rapid development of tachyphylaxis with repeat dosing","volume":"5","author":"McRorie","year":"2014","journal-title":"World J Gastrointest Pharmacol Ther"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1700","DOI":"10.1056\/NEJMcp0804684","article-title":"Clinical practice. Gastroesophageal reflux disease","volume":"359","author":"Kahrilas","year":"2008","journal-title":"N Engl J Med"},{"key":"B19","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1016\/j.pharmthera.2005.05.005","article-title":"Potassium-competitive acid blockade: a new therapeutic strategy in acid-related diseases","volume":"108","author":"Andersson","year":"2005","journal-title":"Pharmacol Ther"},{"key":"B20","doi-asserted-by":"publisher","first-page":"719","DOI":"10.1111\/apt.13325","article-title":"Acid-inhibitory effects of vonoprazan 20\u2005mg compared with esomeprazole 20\u2005mg or rabeprazole 10\u2005mg in healthy adult male subjects\u2013a randomised open-label cross-over study","volume":"42","author":"Sakurai","year":"2015","journal-title":"Aliment Pharmacol Ther"},{"key":"B21","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1007\/s00535-022-01942-z","article-title":"Efficacy and safety of vonoprazan-based regimen for helicobacter pylori eradication therapy in Japanese adolescents: a prospective multicenter study","volume":"58","author":"Kakiuchi","year":"2023","journal-title":"J Gastroenterol"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2024.1305585\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T04:47:46Z","timestamp":1715575666000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2024.1305585\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,13]]},"references-count":21,"alternative-id":["10.3389\/fped.2024.1305585"],"URL":"https:\/\/doi.org\/10.3389\/fped.2024.1305585","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,13]]},"article-number":"1305585"}}