What is the first-line investigation for managing GORD in pediatrics?

The first-line investigation for managing gastroesophageal reflux disease (GORD) in pediatrics is an upper gastrointestinal (GI) study with contrast. This imaging technique allows for direct visualization of the esophagus, stomach, and the duodenum, helping to assess reflux and any associated anatomical abnormalities. The use of contrast helps to highlight the gastrointestinal tract, making it easier to identify reflux episodes and to evaluate the extent of any esophagitis or other complications related to GORD.

Conducting this investigation can provide valuable insights into the condition, guiding further management decisions. Other options, such as CT scans or ultrasounds, are generally not the preferred first-line approaches for assessing GORD, as they are more useful for further investigation of complications or alternative diagnoses. Blood tests for infection do not directly address the assessment or management of GORD and would not typically be used for this purpose. Therefore, the upper GI study with contrast is the most appropriate initial investigation in this scenario.