Gastroesophageal reflux (GER), also called reflux, is when food and acid from the stomach go back up into the esophagus. This causes an uncomfortable feeling in the chest, often called heartburn.
GER can happen in adults and kids, even babies. It’s normal and most kids who have gastroesophageal (gass-troh-eh-soff-eh-JEE-el) reflux outgrow it over time. Changes in diet can help, but some kids might need medical treatment.
Reflux that happens a lot and causes problems like poor growth, vomiting, or damage to the esophagus is called GERD (gastroesophageal reflux disease). GERD is more serious than GER and is usually treated with medicine.
Common signs of reflux include:
Signs of GER in babies and young children include:
Some of these symptoms may get worse if a baby lies down or is placed in a car seat after a meal.
A ring of muscle, called the lower esophageal sphincter, separates the esophagus from the stomach. GER symptoms happen if this ring relaxes at the wrong time or doesn't close as it should. This lets acidic fluid from the stomach flow backward into the esophagus, into the back of the throat, and sometimes out the mouth or nose.
Often, reflux is minor and no cause for concern. But in people who have GERD, reflux happens more often and causes noticeable discomfort. After many meals, they have heartburn (also called acid indigestion).
In babies with GERD, breast milk or formula regularly refluxes into the esophagus, and sometimes out of the mouth. Sometimes babies regurgitate forcefully or have "wet burps."
Babies who have GER usually outgrow it by the time they’re 1 or 2 years old. But in some cases, GER symptoms last. Kids with developmental or neurological conditions, such as cerebral palsy, are more at risk for GER and can have more severe, lasting symptoms.
A steady reflux of stomach acid into the esophagus can lead to:
Because these complications can make eating painful, GER can interfere with proper nutrition. So if your child isn't gaining weight as expected or is losing weight, talk with your doctor.
In older kids, doctors usually diagnose reflux by doing an exam and hearing about the symptoms. If your child has GER symptoms, try to keep track of the foods that seem to cause them. This can help the doctor figure out what's going on.
In younger children and babies, doctors might run these tests to diagnose GER or rule out other problems:
Treatment for GER depends on the symptoms and how severe they are.
Reflux is common in babies, and some simple feeding changes can help:
Don’t let anyone smoke around your baby. Tobacco smoke can make reflux worse.
The doctor may recommend thickening formula with a little bit of oat infant cereal or using an anti-reflux formula to reduce reflux. Breastfed infants with reflux should continue to breastfeed. Talk to your doctor before thickening feedings if your infant is breastfeeding, overweight, or was born early.
Older kids often get relief by avoiding foods and drinks that trigger GER symptoms. Often, these include:
Doctors may recommend raising the head of an older child's bed 6 to 8 inches to help with reflux that happens at night. Infants younger than 1 year old, including infants with gastroesophageal reflux, should always sleep on their backs on a flat, firm surface.
Obesity, some medicines, smoking and alcohol can make GER worse.
If symptoms continue, doctors might prescribe medicine, such as:
Rarely, medical treatment alone doesn't help and a child fails to grow well or has other problems. Then, a surgical procedure might be an option. In this surgery, called fundoplication (fun-doh-plih-KAY-shun), the doctor creates a valve at the top of the stomach by wrapping part of the stomach around the esophagus to strengthen the sphincter and prevent reflux.
Call the doctor if your baby has GER and:
Go to the ER right away if your baby throws up blood or bile (a green or yellow liquid).
Call your doctor if an older child with GER:
Go to the ER right away if your child has severe chest pain.
If your child has GER:
Note: All information is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.
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