Reflux in Children

What is Reflux in Children?

What is reflux (GER) and GERD? Gastroesophageal reflux (GER), often called reflux, occurs when food or stomach acid flows back from your child's stomach into the esophagus. The esophagus is the tube that carries food from your mouth to your stomach. This can sometimes cause irritation or a burning sensation. Occasional reflux is common and usually not a problem. Gastroesophageal reflux disease (GERD) is a more serious and long-lasting type of reflux. GERD can cause repeated symptoms or damage to the lining of the esophagus. Having reflux two or more times a week may be a sign of GERD. Your child's health care provider may diagnose GERD if the reflux causes pain, feeding problems, or irritation of the esophagus. What causes reflux and GERD in children? A small muscle called the lower esophageal sphincter acts as a valve between the esophagus and stomach. When your child swallows, this muscle relaxes to let food pass from the esophagus to the stomach. This muscle normally stays closed, so the stomach contents and acid don't flow back into the esophagus. This muscle, along with the diaphragm (the large muscle between the chest and abdomen), usually prevents reflux. It's normal for children to have reflux occasionally. In children who have GERD, the lower esophageal sphincter may be weak or relax when it shouldn't. That allows stomach contents into the esophagus. This can happen because of: A hiatal hernia, a condition in which the upper part of the stomach pushes up into the chest Increased pressure on the abdomen (belly) from being overweight or having obesity Certain medicines, such as some used to treat asthma, allergies, depression, or pain Smoking or exposure to secondhand smoke Previous surgery on the esophagus or upper abdomen Developmental delays or certain neurological conditions, such as cerebral palsy Lung conditions, such as cystic fibrosis How common are reflux and GERD in children? Many children have occasional reflux, especially after large meals or physical activity. GERD is less common, and most symptoms improve with time and lifestyle changes. What are the symptoms of reflux and GERD in children? Symptoms may vary by age. Some children might not even notice reflux, while others may taste food or stomach acid in the back of their mouth. In children, GERD can cause: Heartburn, a burning feeling in the chest or throat (more common in older children and teens) Bad breath Nausea or vomiting Trouble or pain when swallowing Cough, hoarseness, or breathing problems Wearing away of tooth enamel from stomach acid Other conditions can cause similar symptoms. Talk to your child's provider if symptoms happen often or make eating, sleeping, or daily activities difficult. How are reflux and GERD diagnosed in children? In most cases, your child's provider can tell if it's reflux by learning about your child's symptoms and health history. Tests are usually needed only if symptoms don't get better with lifestyle changes or medicines, or if another health problem is suspected. Common tests include: Upper GI series, which looks at the shape of your child's upper GI (gastrointestinal) tract. Your child will drink or eat a chalky-tasting liquid called barium. For young children, the barium is mixed in with a bottle or other food. Several x-rays are taken to track the barium as it goes through your child's esophagus and stomach. Esophageal pH and impedance monitoring, which measures the amount of acid or liquid in your child's esophagus. A thin flexible tube is placed through their nose into the stomach. The end of the tube in the esophagus measures when and how much acid comes up into the esophagus. The other end of the tube attaches to a monitor that records the measurements. Your child will wear the tube for 24 hours. They may need to stay in the hospital during the test. Upper gastrointestinal (GI) endoscopy and biopsy, which uses an endoscope, a long, flexible tube with a light and camera at the end of it. An endoscope is inserte