Which symptom is the most common presentation of pediatric GERD?

Regurgitation of food is indeed the most common presentation of pediatric gastroesophageal reflux disease (GERD). In younger children, particularly infants, regurgitation can manifest as effortless spitting up after feedings. This symptom occurs when the lower esophageal sphincter is not fully matured, allowing stomach contents to flow back into the esophagus.

It's essential to recognize that this symptom is prominent due to the anatomical and physiological differences in children, where the angle of the esophagus and the immature sphincter mechanism predispose them to reflux. While other symptoms such as decreased appetite, wheezing, and weight loss or poor growth can occur in children with GERD, they are generally not as prevalent as regurgitation. These other symptoms may develop as secondary effects or complications but are less characteristic of the typical presentation of pediatric GERD.

Therefore, regurgitation stands out as the hallmark symptom that clinicians often look for when diagnosing GERD in the pediatric population.