Digestive Function and Abnormalities
Digestion begins as food travels from your mouth to your stomach through the esophagus. Once in the stomach, food is processed before moving to the small intestine. Gastroesophageal reflux (GER) happens when stomach contents flow back into the esophagus. If this regurgitation persists and causes harm to the esophagus or disrupts daily activities like eating and sleeping, it is labeled as Gastroesophageal Reflux Disease (GERD).
Despite often being used interchangeably, GER and GERD are distinct conditions.
Understanding GERD and Reflux in Children
Younger children often exhibit GERD-like symptoms, whereas adolescents and adults typically experience swallowing difficulties and food impaction.
If your child exhibits these symptoms, consult your family doctor or a pediatric gastroenterologist.
GERD symptoms overlap with reflux but may also include failure to thrive, feeding aversion, blood in vomit, breathing noises, chronic cough, and recurring ear infections.
If signs of GERD are present, consulting a pediatrician is advised. Always be alert to "red flags" like fever, lethargy, weight loss, seizures, or breathing issues, indicating conditions beyond GERD.
Diagnosing reflux and GERD involves a comprehensive history evaluation and physical examination to exclude concerning signs.
Various diagnostic tests, such as upper endoscopy, pH probe, and upper GI, may be employed to assess reflux levels and rule out other concerns.
Management of GER involves routine feeding schedules, smaller but frequent feedings, burping, and keeping infants upright post-feeding. Treatments for GERD follow a stepwise approach, starting with dietary adjustments and potentially moving to acid suppression therapies.
Support and Coping
Remember, you are not alone in dealing with GER and GERD. Seeking help and establishing good sleep patterns can alleviate stress. It's crucial to take care of yourself while navigating the challenges of caring for an infant with GER or GERD.
Ensure you are attentive to your own mental well-being, seeking professional help if symptoms of postpartum depression persist.
Reflux & GERD in Infants
It's common for babies to experience reflux, known as spitting up, during their first year of life. The majority of infants go through this phase and are typically healthy. If your baby is growing well and generally happy, reflux is usually not a concern.
However, if your baby displays signs of pediatric GERD such as feeding issues, vomiting, irritability, and breathing difficulties, it's essential to consult a pediatrician promptly. Lifestyle adjustments and medications can often help manage GERD effectively and transform a fussy baby into a content child. With proper treatment, severe cases of reflux and GERD can see improvement, leading to a happy and healthy childhood.
Key Points about Reflux and GERD in Infants
- Most infants do not face problems due to reflux
- Over 50% of babies spit up regularly in the initial months of life
- Reflux typically peaks at 4 months and ceases by 12 to 18 months
- GERD becomes a concern when symptoms like feeding refusal, poor weight gain, and breathing issues manifest
If your baby is spitting up but appears content and healthy, GERD is unlikely. However, if your baby is fussy, not gaining weight, or displaying other GERD symptoms, consulting with a pediatrician is crucial.
Symptoms of GERD in infants may include vomiting, coughing, irritability, poor feeding, poor growth, and breathing problems. While these signs can point to GERD, confirming a diagnosis requires medical evaluation by a pediatrician or a pediatric gastroenterologist.
Lifestyle changes can effectively reduce acid reflux and manage GERD in babies. Strategies like avoiding overfeeding, waiting between feedings, adjusting bottle sizes, thickening formula, keeping the baby upright after meals, and avoiding prolonged time in car seats can be beneficial.
For most infants with reflux or GERD, these lifestyle adjustments are sufficient. In severe or persistent cases, doctors may recommend medications or refer you to a pediatric gastroenterologist for further evaluation and treatment.
Understanding GERD and Reflux in Adolescents and Children
Discovering that you have GERD as a teen can lead to questions about necessary lifestyle adjustments. This realization may introduce new dietary restrictions and perhaps medications, making you feel somewhat isolated.
But here's the reassuring news: You're not facing this alone. In the United States, almost 10 percent of teens and pre-teens grapple with gastroesophageal reflux or GERD. That's quite a substantial number!
Even more encouraging is the fact that most teenagers with acid reflux can pursue normal, vibrant, and healthy lifestyles. By incorporating changes in your routine and exploring various treatments, you'll likely find that you can engage in all your desired activities—be it sports, music, summer camps, or simply spending time with friends. Pediatric acid reflux should not serve as a hindrance to your life.
Acid reflux, also known as gastroesophageal reflux or GER, occurs when stomach contents move upward into the esophagus either during or after a meal.
While it's a common occurrence occasionally, frequent reflux can lead to irritation or harm to the esophagus, indicating the onset of gastroesophageal reflux or GERD.
Symptoms Include:
- Hoarseness
- Frequent regurgitation (stomach contents re-entering the mouth and being swallowed again)
- Painful or challenging swallowing
- Coughing
- Wheezing
- Recurrent pneumonia
If you or your child are experiencing these symptoms, talk with your pediatrician or contact our pediatric gastroenterologist.
Beyond the physical examination, the doctor might suggest tests to investigate if reflux is the root cause. These tests are aimed at examining the esophagus, stomach, and small intestine to identify any underlying issues. Common diagnostic tests include:
X-Rays: Ingestion of barium (a chalky drink) followed by X-rays to visualize the esophagus and stomach's structure.
Endoscopy: After administering sedation, a slender, flexible tube housing a tiny camera is inserted through the mouth into the esophagus and stomach for a thorough examination. The doctor can inspect the lining of the esophagus, stomach, and partial small intestine. If required, small tissue samples (biopsies) might be taken for microscopic scrutiny, looking for inflammation or other concerns. This procedure is painless for the patient.
Esophageal pH Probe: A thin wire with an acid sensor at its end is inserted through the nose into the lower esophagus. This probe can gauge the stomach acid levels reaching the esophagus, determining the presence of acid in the esophagus.
Several effective methods exist for managing and treating this condition. Many teens with GERD discover that they can reduce reliance on medication by implementing specific dietary and lifestyle modifications.
Useful Tips:
- Opt for smaller, more frequent meals
- Restrain from consuming spicy or highly acidic foods (eg. pickles, tomatoes, citrus)
- Consume ample water during symptomatic periods
- Avoid exposure to cigarettes and any form of tobacco smoke
- Steer clear of carbonated beverages, chocolate, caffeine, and high-fat foods (e.g., pizza and french fries)
- Elevate the head of your bed by about 30 degrees
- Avoid tight waistbands
- Consider weight management if you surpass your ideal weight
- Abstain from eating or drinking 2-3 hours prior to bedtime
- Refrain from consuming substantial meals before engaging in intense or stressful activities
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In certain instances, altering diet and lifestyle may not suffice to manage GERD effectively. In such cases, your healthcare provider might suggest medication to alleviate this condition. Medications designed for reflux and GERD focus on reducing the stomach's acid production. Your doctor may prescribe one of several medications, such as:
- Cimetidine (Tagamet)
- Famotidine (Pepcid)
- Nizatidine (Axid)
- Esomeprazole (Nexium)
- Omeprazole (Prilosec)
- Lansoprazole (Prevacid)
- Rabeprazole (Aciphex)
- Pantoprazole (Protonix)
In circumstances where symptoms persist despite medication use, additional tests may be conducted to explore more effective treatment options. In rare cases, surgical intervention could be recommended by your doctor.
Navigating Reflux & GERD Challenges
Coping with GERD:
Receiving an illness diagnosis is seldom easy. Upon discovering that you or your child have acid reflux disease or GERD, you might experience fear, sadness, nervousness, or simply a sense of being "different." Such emotions are entirely normal. If you encounter any of the following indicators, inform your doctor or parents promptly:
- Sleep disturbances
- Profound sadness and frequent crying
- Loss of interest in your regular activities and hobbies
These could signify stress or depression, which warrant attention. It's crucial to communicate your feelings with your parents and medical providers, seeking support to manage your emotions effectively.