Gastroesophageal Reflux In Children

WHAT YOU SHOULD KNOW:

Gastroesophageal reflux (GER) occurs when food, liquid, or acid from your child's stomach backs up into his esophagus. GER often occurs when the lower muscle (sphincter) of your child's esophagus does not close properly. The sphincter normally opens to let food into the stomach. It then closes to keep food and stomach acid in the stomach. If the sphincter does not close properly, food and stomach acid may back up (reflux) into the esophagus.


CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • Your child may have an allergic response to the medicines used to treat his GER. He made need surgery if his symptoms do not improve or become worse. During surgery, your child may bleed more than expected. After surgery, your child may get an infection. Your child's stomach may become swollen or bloated after surgery. His esophagus may swell and make it hard to swallow. He may also be at risk for seizures.

  • Without treatment of GER, your child may get ear, nose, throat, and lung infections more often. Stomach acid reflux may damage his vocal cords. Your child may refuse to eat and drink and he may not grow properly. Your child may also become dehydrated (not enough body fluid). When stomach acid backs up into your child's esophagus, it may damage the tissue lining. The lining of his esophagus may swell and make it hard to swallow. Damaged tissue may cause your child to vomit blood. Over time, the damage GER causes in the esophagus may lead to cancer. If your infant has ALTEs, he may have an increased risk for sudden infant death syndrome (SIDS).

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that your child may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your child's medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done to your child. Make sure all of your questions are answered.

  • Medicine:

    • Histamine type-2 receptor blocker: This group of medicines is also called H2 blockers. They block acid production in your child's stomach.

    • Proton pump inhibitor (PPI): This medicine blocks acid from forming in your child's stomach.

    • Antacids: This medicine decreases the stomach acid that can irritate your child's esophagus and stomach.

    • Prokinetic medicine: Prokinetic medicine decreases the amount of time food stays in your child's stomach. When your child's stomach empties properly, he may have a decreased risk for reflux.

  • Tests:

    • Endoscopy: An endoscopy uses an endoscope to see the inside of your child's digestive tract. An endoscope is a long flexible tube with a light and camera on the end. During an endoscopy, caregivers will look for any tissue damage in your child's esophagus. Caregivers will also look for problems with how your child's digestive tract is working. A biopsy (tissue sample) may be taken from your child's digestive tract and sent to a lab for tests.

    • Esophageal pH monitoring: During esophageal pH monitoring, the pH (acid or base levels) in your child's esophagus is measured. Sensors are put into your child's nose and down into his esophagus. The sensors will normally be left in place for a day. This test measures how much and how often stomach acid refluxes into your child's esophagus.

    • Multichannel intraluminal impedance: Your child's caregiver will put a tube with wires attached to it into your child's nose and down into his esophagus. The wires record the movement and direction of food or acid in your child's esophagus. The tube may also have sensors that measure the pH of your child's stomach acid.

  • Surgery: Surgery may be needed if your child's GER does not improve with other treatments. Ask your child's caregiver for more information about the following:

    • Corrective surgery: Corrective surgery may be needed to correct the function or structure of your child's digestive tract.

    • Fundoplication: During fundoplication surgery, a small part of your child's stomach is wrapped and secured around his lower esophagus. This surgery is done to keep the sphincter muscle tight enough so food and fluids do not reflux.

    • Jejunostomy tube placement: A jejunostomy tube is a feeding tube placed into your child's abdomen below his stomach. Your child can be given liquids and medicines through the tube. With a jejunostomy tube, the risk for reflux decreases. Abdominal swelling can also be decreased by letting air out of an open end of the tube.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Gastroesophageal Reflux In Children (Inpatient Care)

Hide
(web1)