Gastroesophageal Reflux Disease -- Child
(GERD—Child; Chronic Heartburn—Child; Reflux Esophagitis—Child; Gastro-oesophageal Reflux Disease—Child; GORD—Child; Heartburn—Child; Reflux—Child)
Definition
| Gastroesophageal Reflux Disease |
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Causes
- Problems with the nerves that make the valve open or close
- Increased pressure in the stomach
- Irritation in the stomach or muscles of the valve
- Problem with the valve itself
Risk Factors
- Premature birth
- Down syndrome
- Neurological impairments such as intellectual disabilities
- Cerebral palsy
- Head injury
- Hiatal hernia
- Food allergies
- Obesity
- Certain medications
- Exposure to tobacco smoke
- Narrow or short esophagus
- Delayed emptying of the stomach
Symptoms
- Regurgitation or vomiting
- Bloody vomit
- Weight loss or poor weight gain
- Difficulty swallowing
- Pain in the abdomen or chest
- Frequent pneumonia or respiratory problems
- Cough or wheezing
- Hoarseness
- Dental problems due to the effect of the stomach acid on the tooth's enamel
- Feeling full almost immediately after eating
- Chronic heartburn
Diagnosis
- Images may need to be taken of your stomach and esophagus. This can be done with an upper GI series.
- Tests may be done of your bodily tissues. This can be done with an upper endoscopy with biopsy.
- 24-hour pH monitoring—a probe is placed in the esophagus to measure the level of acid
- Short trial of medicine—the doctor may use the success or failure of a medication to understand the cause
Treatment
Lifestyle Changes
-
Your child's doctor may suggest making lifestyle changes before trying medication. These changes may include:
- Eating small, frequent meals
- Avoid eating 2-3 hours before bedtime
- Raising the head of your child’s bed
- Having your child lie on their left side when sleeping
-
Your child may need to avoid certain foods, such as:
- Chocolate
- Fried foods
- Peppermint
- Spicy foods
- Caffeine products
- Carbonated beverages
- Foods high in fat and acid
- If your child is obese, your doctor may recommend weight loss.
- Avoid exposing your child to second hand smoke.
Medications
- Histamine-2 receptor drugs—to decrease acid production and promote healing
- Proton pump inhibitors—also decreases acid production and promote healing
- Promotility drugs—to help stomach emptying, not used often
Procedures
Prevention
- Following recommended lifestyle and dietary changes if your child had GER
- Avoiding second-hand smoke
RESOURCES
North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition http://cdhnf.org
National Digestive Diseases Information Clearinghouse (NDDIC) http://digestive.niddk.nih.gov
CANADIAN RESOURCES
About Kids Health http://www.aboutkidshealth.ca
Canadian Digestive Health Foundation http://www.cdhf.ca
References
Gastroesophageal reflux disease (GERD). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated May 9, 2013. Accessed May 10, 2013.
Gastroesophageal reflux in children and adolescents. National Digestive Diseases Information Clearinghouse website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/gerinchildren/index.htm . Updated August 2006. Accessed May 10, 2013.
Pediatric GE reflux clinical practice guidelines. J Pediatr Gastroenterol Nutr. 2001;32:S1-S31.
Treating GERD. Ohio State University Medical Center website. Available at: http://medicalcenter.osu.edu/patientcare/healthcare%5Fservices/digestive%5Fdisorders/gerd%5Fheartburn/diagnosing%5Ftreating%5Fgerd/treating%5Fgerd/Pages/index.aspx . Accessed May 10, 2013.
3/1/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Maalox Total Relief and Maalox liquid products: medication use errors. US Food and Drug Administration website. Available at: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm200672.htm . Published February 17, 2010. Accessed March 2, 2010.