Gastroesophageal Reflux

Gastroesophageal reflux disease (GERD), sometimes called acid reflux, is a digestive disorder that can occur at any age. The board-certified pediatric gastroenterologists with Norton Children’s Gastroenterology, affiliated with the UofL School of Medicine, have the experience to treat GERD in children.

What Is Gastroesophageal Reflux?

Gastroesophageal reflux (GER) is when the acidic stomach juices, food and/or fluids flow back into the esophagus.

GER is common in children under age 2 and usually does not cause issues. Babies can spit up a few times a day during the first three months of life. They tend to outgrow this by 12 to 14 months old. Older children can experience GER from time to time. GER usually is a temporary condition, but GERD is a more serious and long-term issue.

What Causes Gastroesophageal Reflux Disease in Children?

The most common cause of GER is a relaxing of the lower esophageal sphincter (LES). The LES is a muscle at the bottom of the esophagus; it opens to let food go into the stomach and closes to keep the stomach closed. When the LES relaxes, it lets stomach fluid escape into the esophagus and a child may have a bad taste in their mouth, vomiting or heartburn.

GER becomes GERD when:

  • A baby’s symptoms keep them from feeding
  • A baby has GER for more than 14 months
  • An older child experiences GER more than twice a week for a couple of months

GERD Symptoms in Children

Each child may experience different symptoms. Common symptoms of GERD include:

  • Bad breath
  • Belching or burping
  • Choking
  • Coughing often, with coughing fits at night
  • Fussy attitude around meal times
  • Frequent colds
  • Frequent ear infections
  • Frequent vomiting
  • Gagging
  • Hiccups
  • Rattling sound in the chest
  • Refusing to eat
  • Sore throat in the morning
  • Sour taste in the mouth
  • Stomach pain
  • Tooth enamel decay or loss

GERD Treatment for Children

The board-certified pediatric gastroenterologists with Norton Children’s Gastroenterology will work with you and your child to develop a unique care plan. Treatment will be based on your child’s age, current health and the extent of GERD. Treatment may include:

  • Calorie supplements: Babies unable to gain weight due to frequent vomiting may need a supplemental diet. Your child’s pediatrician may recommend:
    • Adding rice cereal to formula
    • Adding a prescribed supplement to formula or breastmilk
    • Change formula to dairy-free or soy-free formula if an allergy is suspected
  • Medicines to address heartburn, such as H2 blockers or proton pump inhibitors
  • Nasogastric tube feedings: A tube is placed in the nose and guided through the esophagus into the stomach. Tube feedings can be given in addition to or in place of a baby’s bottle.
  • Surgery: Surgery may be considered for severe cases of reflux. The procedure, called fundoplication, is a laparoscopic surgery in which the top part of the stomach is wrapped around the esophagus to strengthen the LES.

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