Treating Pediatric Gastroesophageal Reflux Disease (GERD)
Gastroesophageal reflux (GER) happens when contents from the stomach flow backwards (reflux) into the esophagus (food pipe). To some degree, GER happens in all infants and children, but in some, it causes problems, which is when we say that the child has GER disease (GERD).
In infants, the most common symptom is regurgitation. If reflux is causing a disease, the infant may also have breathing or feeding problems or poor weight gain. In older children, they often complain of heartburn or chest pain or indigestion. Sometimes, they have difficulty or pain while swallowing.
Reflux occurs because of the way liquid moves from the stomach backwards into the food pipe. The size and shape of these organs make infants more likely to have reflux, but as they grow and their feeds change, the reflux improves. Older children can develop reflux because of inflammation in their food pipe or foods or medications that could be triggers.
Infant reflux does not need special testing and improves with time. To diagnose GERD on the other hand, we need to make sure that the reflux is the cause of the problems troubling the infant or child, and many times, this takes specialized testing which can include an upper GI series, esophagogastroduodenoscopy, or pH testing.
Treatment for GER is different from treatment of GERD. Most infants with GER do not require any treatment at all. If they have breathing or feeding problems, then these may require changes in formula or feeding patterns. Sometimes, infants with GERD also require medications to cut down on the amount of acid escaping out of their stomachs, which may be causing irritation to their esophagus. We recommend using caution when using these medications in infants and always discussing with your doctor before starting or stopping. For older children with GERD, treatment with acid-suppressing medications is usually recommended, but equally important are lifestyle changes, including ways to cut back on foods and activities that may trigger the disease.