Which statement distinguishes Gastroesophageal Reflux (GER) from Gastroesophageal Reflux Disease (GERD) in infants?

• A. GERD is characterized by the presence of significant complications.
• B. GER is associated with failure to thrive.
• C. GER is associated with arching of the back and irritability with no other symptoms.
• D. GERD typically requires surgical fundoplication.

Answer: (C)

In infants, telling apart simple reflux from reflux disease hinges on whether there are extra problems beyond the usual regurgitation. GER tends to show up as feeding-related discomfort with regurgitation and irritability, and arching of the back during feeds is a common sign, but there are no other significant issues. GERD, on the other hand, includes pathologic reflux with complications such as poor weight gain, feeding difficulties, persistent vomiting, coughing or wheezing, apnea, or esophagitis. So when arching of the back and irritability occur without any other symptoms or complications, it fits GER rather than GERD. Surgical fundoplication isn’t typically required for GERD in infants and is reserved for severe, refractory cases.