Digestive Diseases: GERD in Infants and Children
It is common for infants to spit up after a meal, but frequent vomiting among infants may be caused by GERD (gastroesophageal reflux disease), the upward movement of stomach content, including acid, into the esophagus and sometimes into or out of the mouth. Older children also can be affected.
What Causes GERD in Infants and Children?
Most of the time, reflux in infants is due to a poorly coordinated gastrointestinal tract. Many infants with the condition are otherwise healthy; however, some infants can have problems affecting their nerves, brain or muscles.
In older children, the causes of GERD are often the same as those seen in adults. Anything that causes the muscular valve between the stomach and esophagus (the lower esophageal sphincter, or LES) to relax, or anything that increases the pressure below the LES, can cause GERD.
Certain factors also may contribute to GERD, including: obesity, overeating, certain foods, some beverages, and specific medications. There also appears to be an inherited component to GERD, as it is more common in some families than in others.
What Are the Symptoms of GERD in Infants and Children?
The most common symptoms are:
- Frequent or recurrent vomiting
- Frequent or persistent cough
- Heartburn, gas, abdominal pain, or colicky behavior (frequent crying and fussiness)
- Regurgitation and re-swallowing
In young infants and children, some problems may be associated with GERD and include:
- Colic (frequent crying and fussiness)
- Feeding problems
- Recurrent choking or gagging
- Poor growth
- Breathing problems
- Recurrent wheezing
- Recurrent pneumonia
Will My Baby Outgrow Infantile GERD?
Yes. Most babies outgrow infantile GERD. However, reflux can occur in older children. In either case, the problem usually can be managed easily.
How Is GERD in Infants and Children Diagnosed?
Usually, parents provide enough details for the doctor to make a diagnosis. Sometimes, however, further tests are recommended. They include:
- Barium swallow or upper GI series. This is a special X-ray test that uses barium to highlight the esophagus, stomach and upper part of the small intestine. This test may identify certain problems such as any obstructions or narrowing in these areas.
- pH probe. This is currently considered the best test to diagnose reflux, but it does not always manage to detect the disease. In this test, a thin tube with a probe at the tip is placed through the nose into the esophagus. The tip, usually positioned at the lower part of the esophagus, measures levels of stomach acids. The frequency of reflux is monitored over a prolonged period of time, usually 24 hours.
- Upper GI endoscopy. During this test the doctor uses an endoscope (a thin, flexible lighted tube) to look directly inside the esophagus, stomach and upper part of the small intestine. Pinch biopsies of the esophagus obtained at the time of endoscopy may determine the presence of reflux.
- Gastric emptying study. During this test, the child drinks milk or eats food mixed with a safe radioactive chemical. This chemical is followed through the gastrointestinal tract using a special camera.
Next: What are the treatments for acid reflux in infants and children? »
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