Gastroesophageal Reflux Disease (GERD)

Gastroesophageal Reflux Disease (GERD) - About

In babies it's called spitting up. In older kids, the signs of reflux and GERD can be burping, stomach aches, and heartburn. Most people experience acid reflux sometimes, and it's usually not a problem. Even infants who spit up frequently are usually perfectly healthy.

However, in some people, reflux happens so frequently and is so severe that it develops into a condition called Gastroesophageal Reflux Disease (GERD). GERD occurs when reflux causes troublesome symptoms or complications such as failure to gain weight, bleeding, respiratory problems or esophagitis.

You can develop GERD at any age. There are some differences between the symptoms, management, and treatment of GERD in infants and GERD in older children and teens. ENT Center of Utah has resources and information about pediatric GERD, whether you have an infant, older child, or if you are a teen with GERD. The most important thing to know is that, with proper treatment, kids with GERD can lead normal, active lives.

Quick Facts about Reflux and GERD

  • In many cases GERD in kids can be managed with lifestyle changes, and without medication
  • GERD often runs in families
  • Kids with GERD may have frequent complaints of abdominal pain or a tummy ache
  • Children and teens with asthma are more likely to have GERD

Gastroesophageal Reflux Disease (GERD) - Diagnosis

The symptoms of childhood GERD are more serious than the occasional stomachache or infrequent act of spitting up. GERD may be present in infants and preschool children if they're:

  • refusing to eat or not gaining any weight
  • experiencing breathing difficulties
  • starting with vomiting at 6 months of age or older
  • fussy or having pain after eating

GERD may be present in older children and adolescents if they:

  • have pain or burning in the upper chest, which is called heartburn
  • have pain or discomfort when swallowing
  • frequently cough, wheeze, or have hoarseness
  • have excessive belching
  • have frequent nausea
  • taste stomach acid in the throat
  • feel like food gets stuck in their throat
  • have pain that's worse when lying down

Long-term bathing of the esophageal lining with stomach acid can lead to the precancerous condition Barrett's esophagus. It can even lead to cancer of the esophagus if the disease isn't effectively controlled, though this is rare in children.

Gastroesophageal Reflux Disease (GERD) - Treatment

Treatment for pediatric GERD depends on the severity of the condition. Doctors will almost always advise parents, children, and teens to start with simple lifestyle changes. For example:

  • Eat smaller meals more often, and avoid eating two to three hours before bedtime.
  • Lose weight if necessary.
  • Avoid spicy foods, high-fat foods, and acidic fruits and vegetables, which can irritate your stomach.
  • Avoid carbonated beverages, alcohol, and tobacco smoke.
  • Elevate the head during sleep.
  • Avoid eating large meals before vigorous activities, sports games, or during times of stress.
  • Avoid wearing tight-fitting clothes.

Your child's doctor may recommend medications that help reduce the amount of acid their stomach produces. These medications include:

  • antacids
  • histamine-2 blockers that reduce acid in the stomach, such as Pepcid and Zantac
  • proton pump inhibitors that block acid, such as Nexium, Prilosec, and Prevacid

There's some debate regarding starting young children on these medications. It's not yet known what the long-term effects of these medications may be. You may want to focus on helping your child make lifestyle modifications. You may also want your child to try herbal remedies. Some parents feel that herbal remedies may be helpful, but the effectiveness of remedies is unproven and the long-term consequences for children taking them are unknown.

Doctors rarely consider surgery as a treatment for pediatric GERD. They generally reserve it for treating cases in which they can't control serious complications, such as esophageal bleeding or ulcers.

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