Your family has just finished dinner when someone at the table starts feeling a burning sensation in their chest. It is not your spouse or Aunt Mabel, but your child. The burning sensation, or heartburn, is one symptom of gastroesophageal reflux disease (GERD).
GERD happens when acid and food flow back up from the stomach and into the esophagus (the tube that connects the mouth to the stomach), potentially damaging the esophagus. GERD can cause chronic problems, such as regurgitation or respiratory problems.
Although symptoms are similar, this is not to be confused with gastroesophageal reflux (GER). GER is common in infants and children. It eventually goes away on its own without treatment.
According to a study in The American Journal of Gastroenterology , children with GERD may be at risk for having this condition as an adult, as well. Fortunately, researchers say that detecting and treating GERD during childhood may result in better outcomes later in life.
GERD is caused by the weakening of a muscle called the lower esophageal sphincter (LES). When you swallow, it contracts to prevent stomach contents from flowing back up, or regurgitating, into the esophagus. Certain foods, medications, and conditions can relax the LES, allowing acid to regurgitate. It may also occur as a result of impaired or absent muscle tone.
If your child has GERD, the doctor may recommend avoiding:
Teenagers should also avoid smoking cigarettes and drinking alcohol, and those with GERD have an added incentive not to. These activities can worsen their symptoms.
Symptoms of GERD in children include:
GERD can cause other health complications for your child that occur over a long period of time. These include:
To help your child communicate how they are feeling and to better understand the symptoms, ask your child the following questions:
GERD can usually be diagnosed based on your child’s symptoms and a physical exam. Additional diagnostic tests are often not required. Once the diagnosis is made, it can be treated through lifestyle changes, medications, and rarely, surgery.
The first step is changing your child’s diet. This may relieve mild symptoms. Avoiding GERD “trigger” foods may be the first step. The doctor may also suggest feeding your child smaller meals and avoiding food 2-3 hours before bedtime. The doctor may also suggest that you elevate the head of your child's bed 6-8 inches (15-20 centimeters) or have your child sleep on the left side.
Medications prescribed to treat GERD in children decrease the amount of acid produced in the stomach. These include H2-blockers and proton pump inhibitors (PPIs).
Surgery, such as a procedure called fundoplication, is rarely used to treat children with GERD. Rather, it is reserved for severe cases or when medications and lifestyle changes do not relieve symptoms.
GERD can be an uncomfortable condition for both you and your child. But, there is help available. Recognizing and relieving symptoms now may benefit your child's health down the line.
Children’s Digestive Health and Nutrition Foundation
International Foundation for Functional Gastrointestinal Disorders
The Canadian Association of Gastroenterology
Dietitians of Canada
El-Serag HB, Gilger M, Carter J, et al. Childhood GERD is a risk factor for GERD in adolescents and young adults. Am J Gastroenterol. 2004;99(5):806-812.
Gastroesophageal reflux. Kids Health—Nemours Foundation website. Available at: http://kidshealth.org/parent/system/surgical/gerd_reflux.html. Updated January 2015. Accessed July 7, 2015.
Gastroesophageal reflux disease (GERD) in infants. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 5, 2015. Accessed July 7, 2015.
Gastroesophageal reflux (GER) and gastroesophageal reflux disease (GERD) in children and teens. National Digestive Diseases Information Clearinghouse, National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/gerinchildren. Accessed July 7, 2015.
Gold BD. Gastroesophageal reflux disease: could intervention in childhood reduce the risk of later complications? Am J Med. 2004;117(Suppl 5A):23S-29S.
Gold BD, Freston JW. Gastroesophageal reflux in children: pathogenesis, prevalence, diagnosis, and role of proton pump inhibitors in treatment. Pediatr Drugs. 2002;4:673-685.
Hassall E. Decisions in diagnosing and managing chronic gastroesophageal reflux disease in children. J Pediatr. 2005;146(Suppl 3):S3-12.
Jung AD. Gastroesophageal reflux in infants and children. Am Fam Physician. 2001 Dec 1;64:1853-1860.
Lightdale JR, Gremse DA, et al. Gastroesophageal reflux: management guidance for the pediatrician. Pediatrics. 2013;131(5):e1684-1695.
Nielsen RG, Bindsley-Jensen C, Kruse-Andersen S, et al. Severe gastroesophageal reflux disease and cow milk hypersensitivity in infants and children: disease association and evaluation of a new challenge procedure. J Pediatr Gastroenterol Nutr. 2004;39(4):383-391.
Last reviewed June 2015 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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