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Gastroesophageal Reflux Disease in Children
WHAT YOU NEED TO KNOW:
What is gastroesophageal reflux disease?
Gastroesophageal reflux occurs when food, liquid, or acid from your child's stomach backs up into his or her esophagus. Gastroesophageal reflux disease (GERD) is reflux that occurs more than twice a week for a few weeks. It usually causes heartburn and other symptoms. GERD can cause other health problems over time if it is not treated.
What causes GERD?
GERD 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. The following may also increase your child's risk for GERD:
- Neurological disorders such as cerebral palsy
- Premature birth
- Parents with GERD
- Hiatal hernia
- Certain foods such as spicy foods, chocolate, foods that contain caffeine, peppermint, and fried foods
- Exposure to secondhand smoke, or smoking cigarettes in adolescents
What are the signs and symptoms of GERD?
- Heartburn (burning pain in his or her chest or below the breast bone) that usually occurs after meals
- Bitter or acid taste in the mouth
- Upper abdominal pain, nausea, or vomiting
- Dry cough, hoarseness, or sore throat
- Trouble swallowing or pain with swallowing
- Gagging or choking while eating
- Poor feeding and growth
- Irritability or crying after eating
How is GERD diagnosed?
Your child's healthcare provider will examine your child. He or she will ask about your child's symptoms and when they started. Tell your child's healthcare provider about your child's medical conditions, eating habits, and activities. Your child's healthcare provider may ask about any family history of GERD. Your child may need any of the following:
- Upper GI x-rays are done to take pictures of your child's stomach and intestines (bowel). Your child may be given a chalky liquid to drink before the pictures are taken. This liquid helps his or her stomach and intestines show up better on the x-rays.
- An endoscopy is a procedure used to look at the inside of your child's esophagus and stomach. An endoscope is a bendable tube with a light and camera on the end. The healthcare provider may remove a small sample of tissue and send it to a lab for tests.
- Esophageal pH monitoring is used to place a small probe inside your child's esophagus and stomach to check the amount of acid.
How is GERD treated?
The goal of treatment is to relieve your child's symptoms and prevent damage to his esophagus. Treatment also helps promote healthy weight gain and growth. Your child may need any of the following:
- Medicines are used to decrease stomach acid. Medicine may also be used to help your lower esophageal sphincter and stomach contract (tighten) more.
- Surgery is done to wrap the upper part of the stomach around the esophageal sphincter. This will strengthen the sphincter and prevent reflux.
What can I do to help my child manage GERD?
- Keep a diary of your child's symptoms. Write down your child's symptoms and what your child is doing when symptoms occur. Bring the diary to your visits with the healthcare provider. The diary may help your child's healthcare provider plan the best treatment for him or her.
- Remind your child not to eat large meals. The stomach produces more acid to help digest large meals, which can cause reflux. Have your child eat 6 small meals each day instead of 3 large ones. He or she should also eat slowly. Your child should not eat meals 2 to 3 hours before bedtime.
- Remind your child not to have foods or drinks that may increase heartburn. These include chocolate, peppermint, fried or fatty foods, drinks that contain caffeine, or carbonated drinks (soda). Other foods include spicy foods, onions, tomatoes, and tomato-based foods. He or she should also not have foods or drinks that can irritate the esophagus. Examples include citrus fruits and juices.
- Elevate the head of your child's bed. Place 6-inch blocks under the head of your child's bed frame to do this. This may decrease your child's reflux while he or she sleeps.
- Help your child maintain a healthy weight. Ask your child's healthcare provider about how to manage your child's weight if he or she is overweight. Being overweight or obese can worsen GERD.
- Your child should not wear clothing that is tight around the waist. Tight clothing can put pressure on your child's stomach and cause or worsen GERD symptoms.
- Keep your child away from cigarette smoke. Do not smoke or allow others to smoke around your child. If your adolescent smokes, encourage him or her to stop. Smoking weakens the lower esophageal sphincter and increases the risk of GERD. Ask your child's healthcare provider for information if your adolescent currently smokes and needs help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Have your adolescent talk to his or her healthcare provider before using these products.
When should I call 911?
- Your child has severe chest pain.
- Your child suddenly stops breathing, begins choking, or his or her body becomes stiff or limp.
When should I seek immediate care?
- Your child has forceful vomiting.
- Your child's vomit is green or yellow, or has blood in it.
- Your child suddenly has trouble breathing or wheezes.
- Your child has severe stomach pain and swelling.
When should I contact my child's healthcare provider?
- Your child becomes more irritable or fussy and does not want to eat.
- Your child becomes weak and urinates less than normal.
- Your child is losing weight.
- Your child has more trouble swallowing than he has before, or he feels new pain when he swallows.
- You have questions or concerns about your child's condition or care.
Care AgreementYou have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. 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.
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