GERD in Children: Understanding the Basics

How Common Is GERD in Children?

Gastroesophageal reflux disorder (GERD) occurs due to the backflow of the acidic contents of the stomach. Such symptoms are mainly seen among adults and the elderly. However, recently, acid reflux in kids has become very common. According to studies, almost 10 to 25 percent of children suffer from this condition.

An alarming rise in GERD in children and toddlers has been observed due to increased obesity and lifestyle changes. In most cases, parents usually neglect such symptoms, assuming they are minor stomach issues. However, neglecting such symptoms at an early age may be fatal.

What Are the Causes of GERD in Children?

Acid reflux issues in children are not common. Certain factors are responsible for these problems. As a result, understanding these factors is crucial to addressing your child’s problem.

• Underdeveloped lower esophageal sphincter (LES):

In our body, the LES acts like a door and prevents stomach content from coming up into our food pipe. In infants, the LES is not fully developed. As a result, the stomach contents may flow back into the esophagus. This usually improves as the child grows older.

• Dietary habits:

If your child consumes excessive amounts of spicy foods, citrus foods, chocolate, caffeine, junk foods, and carbonated soft drinks, they may develop GERD.

• Overeating:

If your child eats a large meal, it can exert pressure on the LES, causing gastric acids to come up. Children who have some eating issues have a higher chance of developing GERD.

• Obesity:

Excess weight can increase abdominal pressure, leading to infant gastroesophageal reflux disease. Obese and inactive children often suffer from such gastric problems.

• Neurological disorders:

Children with certain neurological conditions, such as cerebral palsy, are at higher risk for GERD.

What Are the Symptoms of GERD in Children?

Gastroesophageal reflux disease symptoms in a child are as follows;

• Frequent vomiting or regurgitation, which is known as GERD vomiting.

• GERD often causes heartburn in children or chest pain.

• Abdominal pain.

• Chronic cough.

• Difficulty swallowing.

• Poor growth or weight loss.

• In infants, symptoms might include irritability, refusal to eat, and arching the back during feeds.

• Acid reflux in toddlers at night often causes poor sleep, irritability, and chest pain.

How Do Doctors Diagnose GERD in Children?

If GERD is suspected, a thorough clinical evaluation is essential. Such cases are referred to a pediatric gastroenterologist for evaluation and treatment. This may include:

1. Medical history and physical examination.

2. Tests like the upper gastrointestinal (GI) series (involving X-rays of the stomach, esophagus, and duodenum).

3. Esophageal pH monitoring (Involves the insertion of a thin tube-like device through the mouth into the stomach to measure the pH or acid levels in the esophagus).

4. Endoscopy (insertion of a camera-like device into the stomach through the mouth) of the gastrointestinal tract.

5. Ultrasonography (examination of organs through sound waves) of the abdomen.

What Are the Home Care Tips for Managing GERD?

While medical treatment is sometimes necessary, you can apply some home care tips to manage GERD symptoms in children:

• Diet modification:

Your child should avoid acidic foods, junk foods, spicy foods, and soft drinks. Also, avoid giving your child heavy meals. Your child should not be on an empty stomach for a long time. Small meals at regular intervals are good for your child.

• Positioning:

If your child is an infant, keep them in an upright position for at least 30 minutes after a meal.

• Weight management:

If the child is overweight, a healthy diet and exercise plan can help.

• Avoid smoking exposure:

Secondhand smoke can increase GERD symptoms.

• Comfort and reassurance:

Children with GERD may become anxious about symptoms. Comfort and reassurance from parents are important.

What Is the Management and Treatment of GERD in Children?

If home remedies and lifestyle changes are not working for your child, you should consult a doctor. For proper relief from regular acidity, your child needs both lifestyle modifications and medicational interventions.

1. Medications:

• Antacids:

Antacids can neutralize gastric acid and provide quick relief. However, as they are not suitable for prolonged use, they should only be used under the guidance of a doctor.

• H2 blockers:

These medications reduce acid production. They are effective for many children with mild to moderate symptoms.

• Proton pump inhibitors (PPIs):

For more severe cases, PPIs are often prescribed as these drugs are very effective in reducing acid production.

• Prokinetics:

These drugs can strengthen the lower esophageal sphincter.

2. Surgical options:

Surgery is generally considered only when all other treatments have failed or if there are complications like severe esophageal inflammation, narrowing, or respiratory problems. The most common surgical procedure is fundoplication, where the upper part of the stomach is wrapped around the LES to prevent reflux.

What Are the Complications Associated With GERD in Children That Need Medical Help?

As a parent, you can feel relieved to know that most children with GERD improve as they grow. Some may experience complications such as esophagitis (inflammation of the esophagus), esophageal strictures (narrowing due to scar tissue), or respiratory problems.

Parents must be careful about any of those issues in their children and seek medical attention if they notice any worrying symptoms, such as:

• Difficulty swallowing or painful swallowing.

• Regular vomiting or vomiting of blood.

• Weight loss or poor weight gain in your child.

• Breathing issues like chronic cough or wheezing.

• Vomiting tendency at night due to acid reflux.

• Your child may experience a sour or bitter taste in the mouth in the morning or at night.

The good news is that most children overcome GERD by their first or second year of life, especially as the LES matures and the diet diversifies. For older children, with proper management, GERD can typically be controlled, allowing them to lead normal, active lives.

Conclusion

If your child is facing acidity, it must have been a great concern for you. However, in today's world, such cases are increasing day by day due to lifestyle changes; despite this, GERD symptoms in children are usually manageable with the right combination of medical care and lifestyle modifications. Also, as your child grows older, GERD subsides. This is due to the maturation of the LES and diet changes. Remember, a proactive approach and early intervention can improve the lives of children suffering from GERD. For every case of acid reflux in children, care should be given individually and empathetically.

Key Takeaway From iCliniq

As a parent, you should not ignore any sign of acid reflux in your child. In today's world, GERD in children is increasing due to changes in food habits and lifestyle. That is why taking a few simple steps can improve your child’s health. If you ever need help or have questions about this, you can always consult our iCliniq pediatrician for guidance.