Significant clusterings of reflux symptoms , HH, erosive esophagitis, Barrett’s esophagus (BE), and esophageal adenocarcinoma occur in families, suggesting some heritability of GERD and its complications (33–37). A large Swedish Twin Registry study found an increased concordance for reflux in monozygotic compared with dizygotic twins (33). Several other pediatric patient populations appear to be at higher risk for GERD than healthy infants, children, or adolescents. These include individuals with neurologic impairment (NI), obesity, certain genetic syndromes, esophageal atresia (EA), chronic lung diseases, and those with a history of premature birth. These are discussed in Section 7.

2009 Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN), p. 505.