Gastroesophageal Reflux Disease (GERD) in Children
Stop popping antacids and get to your doctor if heartburn is a regular occurrence. You might have gastroesophageal reflux disease or GERD.
Stop popping antacids and get to your doctor if heartburn is a regular occurrence. You might have gastroesophageal reflux disease or GERD.
When you eat, food travels down your esophagus into your stomach, which produces hydrochloric acid and other digestive juices. A valve at the top of your stomach, called the lower esophageal sphincter (LES), relaxes to let food in, then closes to seal out stomach acid.
The problem starts when the LES stops working properly, relaxing at the wrong time. Then, stomach acid washes up into your esophagus, an event called reflux. A little reflux is normal. In fact, it can happen several times a day in healthy people without causing any symptoms or injury. But a growing number of people and even children suffer from gastroesophageal reflux disease (GERD) — frequent reflux marked by severe symptoms, like heartburn, as well as damage to the esophagus, throat, or respiratory tract. The stomach has a tough lining that protects it from its own digestive juices, but the esophagus doesn’t. Frequent reflux can irritate, inflame, and damage the delicate lining of the esophagus.
There’s a good chance you or your child might have GERD if you experience heartburn more than twice a week. Along with more frequent heartburn, you may see symptoms like these.
•Increased indigestion and regurgitation from your stomach
•Difficulty swallowing or a feeling that food is trapped in your chest
•Bleeding, including vomiting blood or having black or bloody bowel movements
•Loss of appetite or unexplained weight loss
These warning signs are telling you to do something about your GERD before you suffer long-term damage. The more serious consequences are Barrett’s esophagus and esophageal cancer.
You may also experience esophagitis, an inflammation of the esophagus, or esophageal stricture, a narrowing or blockage caused by inflammation and scar tissue. The stomach acid can also get into and damage organs connected to the esophagus, like the trachea (windpipe), larynx (voice box), and lungs.
Antacids and over-the-counter versions of prescription medicines may just cover up symptoms while GERD does more damage. If heartburn bothers you twice or more a week, see your doctor. He can find out if your esophagus is damaged and uncover the cause of your problems.
Several factors seem to raise your risk for GERD, although they don’t necessarily cause it.
•Obesity. Being overweight can double your risk for GERD and related complications, including erosive esophagitis and esophageal cancer. The extra weight puts pressure on your stomach area, which can loosen the LES and force digestive juices into your esophagus.
•Smoking. Tobacco relaxes the LES, allowing stomach acid to creep up into your esophagus. Smoking also boosts acid production and decreases the saliva in your mouth, which might otherwise wash acid back out of your esophagus.
•Alcohol. Drinking alcoholic beverages also relaxes the LES, letting acid wash up into your esophagus.
•Food. What you eat can have a huge impact on heartburn symptoms. Coffee, chocolate, fatty foods, peppermint, sodas, and acidic foods, such as oranges and tomatoes, can aggravate GERD. Different foods may bother different people.
•Hiatal hernia. In some people, part of the stomach bulges through the opening in the diaphragm, crowding the esophagus. This kind of hernia can lead to GERD, though not all people with hiatal hernias have GERD.
•Family history. Your risk for GERD is higher if one of your parents suffered with it.
Your symptoms will probably tell your doctor you have GERD, but he may confirm or expand his diagnosis with one or more of these tests.
•Upper GI endoscopy. Your doctor can scrutinize your esophagus for erosion and inflammation with a tube tipped with a miniature camera. If she finds trouble, she can snip a tiny amount of tissue and have it analyzed, called a biopsy, to find out whether GERD is the culprit.
•Barium swallow. After you swallow barium, a liquid contrast dye, a special X-ray machine makes moving X-rays to show whether the barium backs up into your esophagus after entering your stomach.
•Esophageal manometry. A long, thin tube with a pressure sensor can measure the pressure of your lower esophageal sphincter (LES.) Although this valve should keep stomach acid from escaping into your esophagus, the LES pressure might be too low to prevent it.
•Esophageal pH test. A data recorder and a pH probe — a thin tube with a tiny pH meter at the end — monitor the acidity in your esophagus for 24-hours. If your symptoms match up to episodes of high acidity, you probably have GERD.
Take a close look at what you’re eating. With GERD, you’ll probably get better results cutting out foods and drinks that trigger the condition than to try and find foods to make it better. Most importantly, start cutting fatty foods out of your diet. They cause the stomach to empty slower, so food and acid stick around longer. They also trigger a chemical change that relaxes the LES, letting acid wash up into your esophagus.
Other prime candidates for elimination include:
•chocolate, garlic, onions, and greasy or spicy foods.
•highly acidic foods, such as citrus fruit and juices and tomato products.
•alcohol, caffeine, or carbonated beverages.
•pepper, spearmint, peppermint, mustard, and vinegar.
The same things don’t bother everyone. If you suspect a certain food or beverage is contributing to your problem, stay away from it for several days and see if you feel better. Then notice what happens when you start eating or drinking it again. Try following these general rules to put a cap on GERD.
•Eat more low-acid fruits and vegetables and less high-fat meat and fried food. You can also eat more whole-grain foods to absorb extra stomach acid.
•Skip processed meats. They contain nitrates, chemicals that may increase the risk of esophageal cancer in people with GERD and those taking acid-suppressing medications.
•Drink water throughout the day in small amounts. Drinking too much at one time could distend your stomach and increase your heartburn. Water washes acid out of your esophagus and dilutes the acid in your stomach. But don’t drink liquids with meals since you need stomach acid to digest your food. An hour before or after is best.
Your best defense against GERD is to practice healthy habits that relieve heartburn.
•Quit smoking and avoid alcohol. Both loosen the LES and tend to cause reflux.
•Slim down to a healthy weight. Being overweight puts the squeeze on your stomach and abdomen and may cause the LES to relax.
•Control nighttime eating. Don’t lie down for at least two hours after eating, and don’t eat again for at least two hours before bedtime. This gives stomach acid a chance to decrease before you lie down.
•Sit up straight when you eat. Never stand, lie down, or bend over after eating. This forces food and stomach acid back up into your esophagus.
•Raise the head of your bed about 6 inches by placing blocks under your bedposts, or slide a sleeping wedge under your mattress. This lets gravity keep the contents of your stomach out of your esophagus while you sleep.
Disclaimer: This article is for informational purposes only and is not intended to be a substitute for professional consultation or advice related to your health or finances. No reference to an identifiable individual or company is intended as an endorsement thereof. Some or all of this article may have been generated using artificial intelligence, and it may contain certain inaccuracies or unreliable information. Readers should not rely on this article for information and should consult with professionals for personal advice.