What is GERD?
Gastroesophageal reflux disease (GERD) is a digestive disorder that’s
referred to as pediatric GERD when it affects young people. Nearly 10 percent
of teens and preteens in the United States are affected by GERD according to GIKids.
GERD can be difficult to diagnose in children. How can parents tell the
difference between a little indigestion or the flu and GERD? What does
treatment involve for young people with GERD?
is pediatric GERD?
GERD occurs when stomach acid backs up into the esophagus during or after a
meal and causes pain or other symptoms. The esophagus is the tube that connects
the mouth to the stomach. The valve at the bottom of the esophagus opens to let
food down and closes to stop acid from coming up. When this valve opens or
closes at the wrong time, this may cause symptoms of GERD. When a baby spits up
or vomits, they’re likely displaying gastroesophageal reflux (GER), which is
considered common in infants and usually doesn’t cause other symptoms.
In infants, GERD is a less common, more serious form of spitting up.
Children and adolescents may be diagnosed with GERD if they show symptoms and
experience other complications. The potential complications of GERD include
respiratory problems, difficulty gaining weight, and inflammation of the
esophagus, or esophagitis, according to Johns
Hopkins Children’s Center.
of pediatric GERD
The symptoms of childhood GERD are more serious than the occasional stomachache
or infrequent act of spitting up. According to the Mayo
Clinic, 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
- 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
causes pediatric GERD?
Researchers aren't always exactly sure what causes GERD in young people.
According to Cedars-Sinai,
several factors may be involved, including:
- how long the esophagus is inside of the abdomen
- the angle of His, which is the angle where the stomach
and esophagus meet
- the condition of the muscles at the esophagus’s lower
- pinching of the fibers of the diaphragm
Some children may also have weak valves that are particularly sensitive to
certain foods and beverages or inflammation in the esophagus that’s causing the
is pediatric GERD treated?
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:
- histamine-2 blockers that reduce acid in the
stomach, such as Pepcid and Zantac
- and 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.