GERD (Gastroesophageal Reflux Disease) in Children

GERD stands for gastroesophageal reflux disease. You may also hear it called acid indigestion or heartburn. It happens when stomach contents flow back up (reflux) into the tube that connects the mouth to the stomach. This tube is called the esophagus. GERD can irritate the esophagus. It can cause problems with swallowing or breathing. In severe cases, GERD can cause serious problems, such as pneumonia that keeps coming back. So it's best for any child with GERD to be seen by a healthcare provider.

Signs and symptoms of GERD in children

GERD can cause symptoms such as:

  • A burning feeling in the chest, neck, or throat (heartburn)
  • Feeling of food or liquid coming up in the back of the mouth
  • Gagging, choking, or trouble swallowing
  • Wheezing, or a cough that doesn't go away (persistent cough)
  • Hoarse or raspy voice
  • Bad breath
  • Sore throat in the morning
  • Persistent cough, especially at night or when you wake up

Diagnosing GERD

In some cases, testing may be recommended to find what is causing your child's symptoms. Common tests for diagnosing GERD include:

  • Upper GI series, also called a barium swallow. Barium is a thick, chalky liquid. When swallowed, it makes the esophagus and stomach show up on X-rays.
  • A milk scan. Milk is mixed with a very small amount of a radioactive material. When this is swallowed, the provider can see on a scan if reflux is getting into your child's lungs.
  • Endoscopy. Your child is given a medicine (anesthesia) to make him or her fall asleep. Then a tube (endoscope) with a light and a tiny video camera on it is put down your child's throat. This lets the provider look at your child's esophagus and stomach.
  • 24-hour esophageal pH study. The provider puts a very thin tube into your child's esophagus. This tube is connected to a monitor that records acid levels and reflux activity for a day or longer.

Treating GERD in children

Treatment depends on your child's age, and how severe the symptoms are. Sometimes symptoms can cause poor weight gain. In many cases, making the changes listed in the section below will be enough to ease symptoms. In some cases, medicines may be prescribed to help reduce stomach acid. In rare cases, surgery may be recommended for severe symptoms that don't respond to treatment.

Helping your child feel better

To help prevent or reduce GERD symptoms:

  • Have your child eat smaller but more frequent meals.
  • Make sure your child stops eating at least 3 hours before going to bed.
  • Have your child avoid lying down or reclining for 2 hours after meals.
  • Avoid food and drink that can make GERD worse. These include:
    • Chocolate, peppermint, fizzy drinks, and drinks that have caffeine
    • Acidic foods (such as vinegar, citrus fruits and juices, and tomato products)
    • High-fat foods (such as French fries, fast food, and pizza)
    • Spicy foods
  • Raise the head of your child's bed 5 inches. This can help prevent reflux at night.
  • Make sure your child's clothing is loose and comfortable, especially around the waist.
  • Help your child lose weight if he or she is overweight.
  • Keep tobacco smoke away from your child.