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Our Expert on Children
Q: Could my child have reflux disease?
About Our ExpertPuneet Gupta, M.D. is a pediatric gastroenterologist at Lehigh Valley Health Network.
Q: What is reflux disease?A: Gastroesophageal reflux disease (GERD) is a digestive disorder caused by gastric acid flowing from the stomach up into the esophagus. Babies, children and teens can have GERD, although it is much more common in adults. Q: My six-month-old still spits up a lot after eating. Is this normal, or does he have GERD?A: The valve or sphincter between the esophagus and stomach is very relaxed in babies, allowing the contents of the stomach to back up easily into the esophagus and mouth. Most babies outgrow this normal type of reflux before one year of age, as the sphincter naturally tightens. (If your child cries after feeding, has poor weight gain or vomits blood, the problem is more serious; call your pediatrician or a pediatric gastroenterologist.) Q: What are the symptoms of GERD in older children?A: The most common symptom is heartburn, also called acid indigestion. Often worse after eating, heartburn is a burning pain that starts behind the breastbone and moves upward to the neck and throat. Other symptoms may include stomach ache, fussiness at mealtime, vomiting, frequent cough, or wheezing. Q: Why is GERD a concern?A: Babies and children with GERD who vomit frequently may not gain weight and grow normally. Stomach acid can cause inflammation or ulcers in the esophagus, or it may spill into the windpipe, causing asthma or pneumonia. Q: How is GERD diagnosed?A: Your child’s physician may perform an endoscopy, a procedure that uses a small, flexible tube (inserted through the mouth) equipped with a tiny camera to examine the inside of the digestive tract. The doctor also may take small tissue samples for further evaluation. Your child will be given a sedative before the procedure. Q: What is the treatment for GERD?A: Treatment depends on the age of your child and the severity of the symptoms. Usually antacids (H-2 blockers like Zantac) help by keeping acid formation in the stomach. Another class of drugs, proton pump inhibitors (like Nexium), work by limiting the production of stomach acid. In many cases, GERD can be relieved through diet and lifestyle changes. These include smaller, more frequent meals; no spicy or acid foods; no eating 2-3 hours before bedtime; and no soda, chocolate or caffeine. Elevating the head of your child’s bed also may help. Obesity increases the risk for GERD, so if your child is overweight, take a look at his or her eating habits and exercise level. Your doctor can help. Q: Will my child outgrow this?A: Some children may be predisposed to GERD and will need to deal with it all their lives. With lifestyle changes and medication, most children and teens develop a normal digestion process. This page last updated 10/15/08 04:51 PM
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