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GERD, or gastroesophageal reflux disease, is a long-term (chronic) digestive disorder. It happens when stomach contents flow back up (reflux) into the food pipe (esophagus).
GERD is a more serious and long-lasting form of gastroesophageal reflux (GER).
GER is common in babies under 2 years old. Most babies spit up a few times a day during their first 3 months. GER does not cause any problems in babies. In most cases, babies outgrow this by the time they are 12 to 14 months old.
It is also common for children and teens ages 2 to 19 to have GER from time to time. This doesn’t always mean they have GERD.
Your baby, child, or teen may have GERD if:
GERD is often caused by something that affects the LES, the lower esophageal sphincter. The LES is a muscle at the bottom of the food pipe (esophagus). The LES opens to let food into the stomach. It closes to keep food in the stomach. When the LES relaxes too often or for too long, stomach acid flows back into the esophagus. This causes vomiting or heartburn.
Everyone has reflux from time to time. If you have ever burped and had an acid taste in your mouth, you have had reflux. Sometimes the LES relaxes at the wrong times. Often your child will just have a bad taste in his or her mouth. Or your child may have a short, mild feeling of heartburn.
Babies are more likely to have a weak LES. This makes the LES relax when it should stay shut. As food or milk is digesting, the LES opens. It lets the stomach contents go back up to the esophagus. Sometimes the stomach contents go all the way up the esophagus. Then the baby or child vomits. In other cases, the stomach contents only go part of the way up the esophagus. This causes heartburn or breathing problems. In some cases there are no symptoms at all.
Some foods seem to affect the muscle tone of the LES. They let the LES stay open longer than normal. These foods include:
Other foods cause the stomach to make more acid. These foods include:
Other things that may lead to GERD include:
GERD is very common during a baby’s first year of life. It often goes away on its own. Your child is more at risk for GERD if he or she has:
Heartburn, or acid indigestion, is the most common symptom of GERD. Heartburn is described as a burning chest pain. It begins behind the breastbone and moves up to the neck and throat. It can last as long as 2 hours. It is often worse after eating. Lying down or bending over after a meal can also lead to heartburn.
Children younger than age 12 will often have different GERD symptoms. They will have a dry cough, asthma symptoms, or trouble swallowing. They won’t have classic heartburn.
Each child may have different symptoms. Common symptoms of GERD include:
Other symptoms may include:
GERD symptoms may seem like other health problems. Make sure your child sees his or her healthcare provider for a diagnosis.
Your child's healthcare provider will do a physical exam and take a health history. Other tests may include:
Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.
In many cases, diet and lifestyle changes can help to ease GERD. Talk with your child’s healthcare provider about changes you can make. Here are some tips to better manage GERD symptoms.
Other things to try:
Your child’s healthcare provider may also recommend other options.
Medicines. Your child's provider may prescribe medicines to help with reflux. There are medicines that help reduce the amount of acid the stomach makes. This reduces the heartburn linked to reflux. These medicines may include:
The provider may prescribe another type of medicine that helps the stomach empty faster. If food doesn’t stay in the stomach as long as normal, reflex may be less likely to occur.
Calorie supplements. Some babies with reflux can’t gain weight because they vomit often. If this is the case, your child's healthcare provider may suggest:
Tube feedings. In some cases tube feedings may be recommended. Some babies with reflux have other conditions that make them tired. These include congenital heart disease or being born too early (premature). These babies often get sleepy after they eat or drink a little. Other babies vomit after having a normal amount of formula. These babies do better if they are constantly fed a small amount of milk. In both of these cases, tube feedings may be suggested. Formula or breastmilk is given through a tube that is placed in the nose. This is called a nasogastric tube. The tube is then put through the food pipe or esophagus, and into the stomach. Your baby can have a tube feeding in addition to a bottle feeding. Or a tube feeding may be done instead of a bottle feeding. There are also tubes that can be used to go around, or bypass, the stomach. These are called nasoduodenal tubes.
Surgery. In severe cases of reflux, surgery called fundoplication may be done. Your baby’s provider may recommend this option if your child is not gaining weight because of vomiting, has frequent breathing problems, or has severe irritation in the esophagus. This is often done as a laparoscopic surgery. This method has less pain and a faster recovery time. Small cuts or incisions are made in your child’s belly. A small tube with a camera on the end is placed into one of the incisions to look inside. The surgical tools are put through the other incisions. The surgeon looks at a video screen to see the stomach and other organs. The top part of the stomach is wrapped around the esophagus. This creates a tight band. This strengthens the LES and greatly decreases reflux.
Some babies and children who have GERD may not vomit. But their stomach contents may still move up the food pipe (esophagus) and spill over into the windpipe (trachea). This can cause asthma or pneumonia.
The vomiting that affects many babies and children with GERD can cause problems with weight gain and poor nutrition. Over time, when stomach acid backs up into the esophagus, it can also lead to:
Adults may also have long-term problems from inflammation of the esophagus. These include:
Call you child's healthcare provider if your baby or child:
Bayhealth is Southern Delaware’s healthcare leader with hospitals in Dover and in Milford. Bayhealth provides a wide range of medical services, including cardiovascular, cancer, orthopaedics and rehabilitation, pediatrics, respiratory care, sleep care, surgical weight loss and women’s services.