Gastroesophageal Reflux

When children repeatedly experience the symptoms of acid indigestion (commonly called “heartburn”), they may have a problem with their digestive system. Acid indigestion can be caused by the contents of the stomach backing up into the esophagus. This is referred to as gastroesophageal reflux.

You should consult your doctor if you think that you or your child has any persistent health problems or complaints. Your doctor can provide strategies or medical treatments for controlling the disorder.

What is Gastroesophageal Reflux (GERD)?

The esophagus is the muscular tube that connects the mouth to the stomach. Chewed food, fluids and saliva flow down the esophagus from the mouth to the stomach. When the contents of the stomach (including acids and other digestive juices) back up into the esophagus, this is referred to as gastroesophageal reflux. This reflux, or backward flow, of fluid can be caused by the weakness or improper functioning of the lower esophageal sphincter, a muscle that acts as a valve that opens to allow food to enter the stomach. When it is working properly, it keeps any fluid from flowing back up into the esophagus.

Treatment for Gastroesophageal Reflux

If the other strategies are not helpful and your child continues to experience gastroesophageal reflux, your doctor can prescribe medication that may help with the symptoms. In extreme cases, surgery may be necessary.

Symptoms of Gastroesophageal Reflux in Infants

Occurring soon after eating:

  • Vomiting
  • Coughing episodes
  • Difficulty breathing (from inhalation of stomach contents)
  • Irritability (from the discomfort or burning sensations of acid indigestion)

Symptoms of Gastroesophageal Reflux in Children

Occurring soon after eating:

  • Pain or burning sensation behind the breastbone that moves toward the neck (acid indigestion or “heartburn”)
  • Acidic or bitter taste in the mouth (stomach contents flowing up the esophagus into the mouth)
  • Vomiting
  • Coughing episodes
  • Belching episodes
  • Feeling pain when swallowing

Occasionally GERD presents as a chronic cough, chest pain, or even wheezing, and may be confused with asthma.  Lung function tests can help determine whether your child’s symptoms are due to asthma or due to GERD.

Strategies for Controlling Gastroesophageal Reflux in Infants

Gastroesophageal reflux is most likely to occur when a child is lying flat. The following strategies may minimize reflux:

  • Burp your infant several times during and after feeding.
  • Position the infant upright for about 30 minutes after feeding.

Strategies for Controlling Gastroesophageal Reflux in Children

  • Do not eat within two to three hours before bedtime.
  • Avoid beverages that contain caffeine, since caffeine can relax the lower esophageal sphincter (many sodas contain caffeine, so check the labels).
  • Avoid fried or fatty foods, chocolate and peppermint.
  • Avoid foods with high acid content, like tomatoes and citrus fruits.
  • Avoid spicy foods.
  • Raise the head of the child’s bed or provide extra pillows so that their head and chest are elevated while sleeping.
  • If your child is overweight, help him or her lose weight through diet and increased physical activity.

 

(Adapted from American Medical Association)

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