6.1.4. The Child Older Than 18 Months of Age With Chronic Regurgitation or Vomiting Physiologic regurgitation, episodic vomiting, or regurgitation followed by swallowing of refluxate in the mouth are frequent in infants. Whether of new onset or persisting from infancy, these symptoms are less common in children older than 18 months of age. Although these symptoms are not unique to GERD, evaluation to diagnose possible GERD and to rule out alternative diagnoses is recommended based on expert opinion. Testing may include upper GI endoscopy and/or esophageal pH/MII, and/or barium upper GI series.