Gastroesophageal reflux disease (GERD) is a digestive disorder that is caused by gastric acid flowing from the stomach into the esophagus. Gastroesophageal refers to the stomach and esophagus, and reflux means to flow back or return.
Gastroesophageal reflux (GER) is the return of acidic stomach juices, or food and fluids, back up into the esophagus. GER is very common in infants, though it can occur at any age. It is the most common cause of vomiting during infancy.
Some infants and children who have gastroesophageal reflux may not vomit, but may still have stomach contents move up the esophagus and spill over into the windpipe. This can cause asthma, pneumonia and possibly SIDS (sudden infant death syndrome).
Infants and children with GERD who vomit frequently may not gain weight and grow normally. Inflammation (esophagitis) or ulcers (sores) can form in the esophagus due to contact with stomach acid.
GERD is often the result of conditions that affect the lower esophageal sphincter (LES). The LES, a muscle located at the bottom of the esophagus, opens to let food in and closes to keep food in the stomach. When this muscle relaxes too often or for too long, acid refluxes back into the esophagus, causing vomiting or heartburn.
Everyone has gastroesophageal reflux from time to time. If you have ever burped and had an acid taste in your mouth, you have had reflux. The lower esophageal sphincter occasionally relaxes at inopportune times, and usually, all your child will experience is a bad taste in the mouth or a mild, momentary feeling of heartburn.
Infants are more likely to have the lower esophageal sphincter (LES) relax when it should remain shut. As food or milk is digesting, the LES opens and allows the stomach contents to go back up the esophagus. Sometimes, the stomach contents go all the way up the esophagus, and the infant or child vomits. Other times, the stomach contents only go part of the way up the esophagus, possibly causing heartburn or breathing problems.
Some foods seem to affect the muscle tone of the lower esophageal sphincter, allowing it to stay open longer than normal. These include, but are not limited to, the following:
Heartburn, also called acid indigestion, is the most common symptom of GERD. Heartburn is described as a burning chest pain that begins behind the breastbone and moves upward to the neck and throat. It can last as long as two hours and is often worse after eating. Lying down or bending over can also result in heartburn. The following are other common symptoms of GERD. However, each child may experience symptoms differently. Symptoms may include:
The symptoms of GERD may resemble other conditions or medical problems. Consult your child's physician for a diagnosis.
Your child's physician will perform a physical examination and obtain a medical history. Diagnostic procedures that may be done to help evaluate GERD include:
Specific treatment will be determined by your child's physician based on the following:
In many cases, GERD can be relieved through diet and lifestyle changes, under the direction of your child's physician. Some ways to better manage GERD symptoms include the following:
If needed, your child's physician may prescribe medications to help with reflux or other treatment methods.
Many infants who vomit will "outgrow it" by the time they are about a year old, as the lower esophageal sphincter becomes stronger. For others, medications, lifestyle and diet changes can minimize reflux, vomiting, and heartburn.