Everyone has Gastroesophageal reflux or the backward movement of gastric contents into the esophagus, at some time or the other. In infants, more than 50% of children three months or younger experience at least one episode of regurgitation a day. At four months this rate goes up to 67%.
But an improvement in an infant$%:s neuromuscular control and the ability to sit up tends to take care of GERD and by the age of 18 months for most of them GERD is a distant phenomenon.
GERD occurs when the muscular valve at the lower end of the esophagus malfunctions and somehow opens up and allows acid from the stomach to back into the esophagus $%: prolonged exposure to the acid can cause significant injury to the lining of the esophagus $%: and it is estimated that about 5 to 8% of adolescent children suffer from this disease.
Heartburn, the most common symptom of GERD is difficult for children to explain. They usually complain of stomachache or chest discomfort, predominantly after meals. Frequent or severe GERD can cause other problems in the esophagus, stomach, pharynx, larynx, lungs, sinuses, ears and even teeth. The typical symptoms could include poor appetite and swallowing difficulties, failure to gain weight, dyspepsia, abdominal or chest pain, regurgitation, sore throat, asthma, chronic sinusitis, ear infections and dental caries.
In contrast to infants, the adolescent child$%:s GERD will not take care of itself and if your child displays typical GERD symptoms, a visit to the pediatrician is required.
Most often, the physician can make a diagnosis by interviewing the caregiver and examining the child. Sometimes, testing might be required such as the ph probe, the Barium swallow or upper GI series, Tecnetium Gastric Emptying Study,Fiberoptic Laryngoscopy and the most comprehensive procedure Endoscopy with biopsies.
In infants the treatment of reflux is more geared towards alleviating the symptoms and not relieving the underlying problem, as this tends to resolve over time. A rather simple and useful treatment is to thicken the baby$%:s milk formula with rice cereal causing it less likely to be an acid reflux treatment.
For an older child, simple lifestyles changes such as raising the head of the bed to about 30 degrees while sleeping and making sure the child eats smaller, more frequent meals rather than large amounts of food at one sitting, can be helpful. Ensuring that the child eats at least two to three hours before bedtime will also help. Dietary changes such as avoiding chocolate, aerated drinks, caffeine, tomato products, peppermint and other acidic foods or citrus juices and fried or spicy foods should help reduce the problem.
Most medications prescribed for GERD work on reducing or breaking down intestinal gas and neutralizing stomach acid.
It is quite rare for children with GERD to undergo surgery. Nissen fundoplication is the surgical procedure used on the few who do have to be operated upon.
If your bundle of joy is always crying, irritable , throwing up and just plain miserable, eliminating the possibility of GERD would be a judicious move.