Information provided by the National Institute of Diabetes and Digestive and Kidney Diseases
What is GER?
Gastroesophageal reflux (GER) occurs when stomach contents flow back up into the esophagus—the muscular tube that carries food and liquids from the mouth to the stomach.
GER is also called acid reflux or acid regurgitation because the stomach’s digestive juices contain acid. Sometimes people with GER can taste food or acidic fluid in the back of the mouth. Refluxed stomach acid that touches the lining of the esophagus can cause heartburn. Also called acid indigestion, heartburn is an uncomfortable, burning feeling in the mid-chest, behind the breastbone, or in the upper part of the abdomen—the area between the chest and the hips. Occasional GER commonly occurs in children and adolescents––ages 2 to 19––and does not always mean they have GERD.
Children and adolescents may be able to control GER by:
- Avoiding foods and beverages that contribute to heartburn, such as chocolate, coffee, peppermint, greasy or spicy foods, tomato products, and alcoholic beverages.
- Avoiding overeating
- Quitting smoking
- Losing weight if they are overweight
- Not eating two to three hours before sleep
- Taking over-the-counter medications
What is GERD?
Gastroesophageal reflux disease (GERD) is a more serious, chronic––or long lasting–– form of GER. GER that occurs more than twice a week for a few weeks could be GERD, which over time can lead to more serious health problems. If caregivers suspect their child or adolescent has GERD, they should take their child or adolescent to see a pediatrician—a doctor who specializes in treating children and adolescents.
What causes GERD in children and adolescents?
Gastroesophageal reflux disease results when the lower esophageal sphincter—the muscle that acts as a valve between the esophagus and stomach—becomes weak or relaxes when it should not, causing stomach contents to rise up into the esophagus.
Other factors that can contribute to GERD include:
- Obesity
- Certain medications, such as asthma medications and many antihistamines, pain killers, sedatives, and antidepressants
- Smoking, which is more likely with adolescents than younger children, or inhaling secondhand smoke
Children who have a history of esophageal surgery and children with severe developmental delays are more likely to develop GERD. Pregnant adolescent girls may also develop GERD symptoms. Any child or adolescent can develop GERD, some for unknown reasons.
What is the gastrointestinal (GI) tract?
The GI tract is a series of hollow organs joined in a long, twisting tube from the mouth to the anus. The movement of muscles in the GI tract, along with the release of hormones and enzymes, starts the digestion of food. The upper GI tract includes the mouth, esophagus, stomach, small intestine, and duodenum, which is the first part of the small intestine.
What are the symptoms of GERD in children and adolescents?
In older children and adolescents, the main symptom of GERD is frequent heartburn. Most children with GERD who are younger than 12 do not have heartburn. Other common GERD symptoms include:
- A dry, chronic cough
- Wheezing
- Asthma or recurrent pneumonia
- Nausea
- Vomiting
- A sore throat, hoarseness, or laryngitis— swelling and irritation of the voice box
- Difficulty swallowing or painful swallowing
- Pain in the chest or the upper part of the abdomen
- Dental erosion and bad breath
Caregivers should call a pediatrician right away if their child or adolescent:
- Vomits large amounts or has persistent projectile, or forceful, vomiting
- Vomits fluid that is green or yellow, looks like coffee grounds, or contains blood
- Has difficulty breathing after vomiting
- Has pain related to eating
- Has difficulty swallowing or painful swallowing
- Refuses food repeatedly, resulting in weight loss or poor weight gain
- Shows signs of dehydration, such as no tears when crying
How is GERD diagnosed in children and adolescents?
A pediatrician may refer children and adolescents with suspected GERD to a pediatric gastroenterologist—a doctor who specializes in childhood and adolescent digestive diseases—for diagnosis and treatment.
Lifestyle changes and medications are often the first lines of treatment for suspected GERD. If symptoms improve with these treatment methods, a GERD diagnosis for a child or an adolescent often does not require testing. However, to confirm a diagnosis, a child or an adolescent may need testing if symptoms do not improve. Children and adolescents with possible GERD who have trouble swallowing also may require testing.
This is part one of a series. Please join us next month for further information in regards to GER and GERD as diagnosed in children and adolescents. For more information visit www.niddk.nih.gov.