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Table 2 Recommended diagnostic procedures for GER/GERD focusing only on infants with apnoea or ALTE [37]

From: Apparent Life-Threatening Events (ALTE): Italian guidelines

Diagnostic investigation When to perform it
pH-monitoring, or better, pH- impedance if available - suspected recurrent aspiration pneumonia
- unexplainable apnoeas or inflammation of the upper airways or non-epileptic simil-convulsive episodes or apparent Sandifer Syndrome
Upper endoscopy - reported haematemesis not caused by ingested blood
- persistent regurgitation after the first year of life
- prolonged refuse to eat or persistent poor growth associated with regurgitation
- unexplainable iron-deficiency anaemia
- suspected Sandifer Syndrome