Effectiveness of dietary interventions in managing pediatric gastroesophageal reflux disease: a comprehensive systematic review.

Abstract

<h4>Background</h4>Pediatric gastroesophageal reflux disease (GERD) is a common chronic digestive disorder that significantly impacts children's growth, development, and quality of life. Traditional management of GERD often involves pharmacological interventions, such as proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2RAs), which raise concerns about side effects and long-term safety. Recently, interest has shifted toward dietary interventions as complementary or alternative approaches to managing GERD symptoms.<h4>Objective</h4>This systematic review aims to evaluate the efficacy of various dietary interventions, including low-fat diets, plant-based diets, exclusion diets, and nutraceuticals such as probiotics, in managing pediatric GERD symptoms and promoting overall digestive health.<h4>Methods</h4>A comprehensive search was conducted across PubMed, MEDLINE (Ovid), Embase, Web of Science, and Cochrane databases up to March 2024. Studies investigating dietary interventions for pediatric GERD published in English were selected. Risk of bias was assessed using the modified ROBVIS2 tool, and results were synthesized through narrative and thematic analysis.<h4>Results</h4>Eleven studies were included in the review. Evidence on low-fat versus full-fat dairy diets showed mixed results, with no clear consensus on their impact on GERD symptoms. Plant-based and exclusion diets demonstrated significant improvements in GERD symptoms, likely due to their anti-inflammatory properties and the elimination of dietary triggers. Probiotics emerged as a promising intervention, reducing GERD symptoms by enhancing gut barrier function and modulating inflammation. However, the studies varied in design, and adherence to dietary interventions was identified as a key challenge, particularly in pediatric populations.<h4>Conclusion</h4>Although current evidence remains limited, this review highlights promising dietary strategies-especially plant-based diets and probiotics-for managing pediatric GERD. Future research should focus on personalized nutrition and long-term effectiveness to validate these non-pharmacological interventions.