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Gastroesophageal reflux disease (GERD) in children

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Gastroesophageal reflux disease (GERD) in children is a chronic digestive disorder where stomach acid frequently flows back into the esophagus, causing irritation and discomfort. GERD is similar in children and adults but can present differently in children. Here are key points to understand about GERD in children:

Causes:

  • In infants, GERD is often due to an underdeveloped lower esophageal sphincter (LES), the muscle that separates the esophagus from the stomach. In older children, it can be caused by a weak LES or other factors.

Symptoms:

  • GERD symptoms in children can include:
    • Frequent spitting up or regurgitation.
    • Heartburn or chest pain (rare in children).
    • Frequent coughing or wheezing.
    • Refusing to eat or difficulty eating.
    • Fussiness or irritability, particularly during or after feeding.
    • Poor weight gain or growth (failure to thrive).
    • Recurrent ear infections or sinusitis.
    • Hoarse voice or chronic sore throat.
    • Bad breath.
    • Dental problems (due to stomach acid affecting the teeth).

Diagnosis:

  • A pediatrician will typically diagnose GERD based on a child’s symptoms and medical history.
  • In some cases, further tests such as an upper gastrointestinal (GI) series, pH probe monitoring, or endoscopy may be performed to confirm the diagnosis and assess the severity of reflux.

Treatment:

  • The treatment of GERD in children can vary based on the child’s age and the severity of symptoms. It may include:
    • Lifestyle and dietary changes: Elevating the head of the bed, smaller and more frequent meals, avoiding trigger foods (e.g., citrus, caffeine), and avoiding large meals close to bedtime.
    • Medications: Doctors may prescribe acid-suppressing medications such as H2 blockers or proton pump inhibitors (PPIs) in some cases. These medications reduce stomach acid production and can provide relief.
    • Thickening feeds: For infants with GERD, adding a thickening agent to formula or breast milk may help reduce reflux.
    • Surgical intervention: In rare cases where medications and lifestyle changes are ineffective or severe complications occur, surgery (fundoplication) may be considered.

Monitoring and Follow-Up:

  • Children with GERD may require ongoing monitoring and adjustments to their treatment plan to manage symptoms effectively.
  • Regular follow-up appointments with a pediatrician or pediatric gastroenterologist are important to assess growth and adjust treatment as needed.

Complications:

  • If left untreated, GERD in children can lead to complications such as esophagitis (inflammation of the esophagus), strictures (narrowing of the esophagus), respiratory issues, and dental problems.

Parental Support:

  • Parents play a crucial role in managing a child’s GERD. They should work closely with healthcare providers to monitor symptoms and follow treatment recommendations.
  • Addressing feeding issues, ensuring proper positioning during and after meals, and providing emotional support are essential aspects of care.

GERD in children can significantly affect a child’s quality of life and development. Early diagnosis and appropriate management can help alleviate symptoms and prevent complications. Parents should seek medical attention if they suspect their child has GERD or if symptoms persist despite initial interventions.

The Pediatric.me content is provided for informational purposes only and is not intended as medical advice or as a substitute for medical advice of a physician