What symptoms and risk factors predict pathological GERD in infants?

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Infants who reflux more than 5 times a day are more likely to have pathological gastroesophageal reflux disease (GERD), although the positive predictive value is only 29% (SOR: C, moderate and low-quality evidence from observational studies). Symptoms such as persistent crying, back arching, hiccupping, coughing, and vomitus volume do not correlate with abnormal esophageal pH or esophagitis on biopsy. Pneumonia, apnea with fussing, and defecation less than once a day are associated with abnormal esophageal pH (SOR: C, moderate quality evidence from observational studies).

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