| Children and GERD |
| Written by James Black | |
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While gastroesophageal reflux disease is commonly associated with older adults, infants and children can also suffer from GERD. The symptoms of this illness may sometimes be difficult to discern from other illnesses because of their similarity with more common childhood problems and the tendency to associate GERD with adults. According to the Archives of Pediatric and Adolescent Medicine, about three to five percent of all children may suffer from GERD.
Gastroesophageal reflux disease is basically caused by a weakness or malfunction of the esopheagal sphincter, the valve that separates the esophagus from the digestive tract. When the esopheagal sphincter isn't working properly, it allows stomach acid to flow back into the esophagus, causing irritation of the lining that results in severe discomfort. Reflux in babies is fairly common, and is generally caused by an immature gastrointestinal tract. In fact, about half of all infants experience recurrent vomiting, with its incidence peaking at about the age of four months. Kids generally grow out of it as their bodies develop, and usually by age 1 problems with GERD are resolved. In young children, there are a variety of symptoms that can point to GERD. For example, if your infant or toddler is having frequent vomiting, refuses to eat much, has periodic bouts of colic and isn't growing as quickly as he or she should be, chances are that your child may have GERD. There are several tests your pediatrician can perform to determine whether your child has GERD. In an upper GI series, your health care provider will have your child drink barium and then use an x-ray to examine the esophagus and upper intestine and stomach. If your health care provider opts for a pH probe, your child will have to swallow a long thin tube tipped with a probe that will remain within your child's esophagus for a day. This probe will measure levels of stomach acids. (This test is generally done on older children.) In a gastric emptying stydy, your child will consume food or drink containing a radioactive chemical. A special camera follows the chemical through your child's gastrointestinal tract. There's a variety of measures that your pediatrician may suggest to help your child deal with GERD. These treatments include lifestyle changes, medicines and surgery. In infants, changes to the child's feeding habits are the most commonly used form of treatment because they're the least invasive and usually very effective. For example, certain simple changes to feeding habits can have a positive impact on treating GERD. For example, getting rid of cow's milk from an infant's diet has been shown to help reduce vomiting within a day in infants who may have a milk allergy. The milk can be replaced with formula milk, such as Enfamil or Similac. Other infants with an intolerance to the protein casein hydrolysate will need to try another tactic, such as an amino-acid based formula like EleCare or Neocate. You can also help reduce the occurrence of GERD by thickening the infant's milk with oatmeal or light cereal. Positional therapy is another often suggested treatment for GERD among infants. For example, by elevating your infants head on your shoulder for about half an hour after feeding, you may greatly reduce his or her GERD symptoms. In older children, the symptoms of GERD are pretty much synonymous with those experienced by adults. Once again changes in diet and lifestyle can make a big difference in treating GERD symptoms. If your child has GERD, you'll want to encourage him or her to avoid caffinated beverages, eat foods low in acid content and avoid having large meals in favor of eating several smaller meals per day. This may be difficult in a school setting, but a consultation with your child's school principal and cafeteria head may help you accomodate your child's dietary needs. Prescription drugs and surgery are more agressive measures that your health care provider may suggest if your child's GERD presents an intractable problem. Some common prescription drugs given to children with GERD. Milder antacids are generally the first course of treatment, but are discouraged as a long term solution because they can cause frequent constipation. The FDA recently approved the use of Nexium to treat GERD in children ages 1-11 over an eight-week period. If medication proves unable to handle the problem, surgery may be an option. The most common form of surgical treatment of GERD in children is the Nissen fundoplication, which wraps part of the esophagus and the stomach together, strengthening the esophegal sphincter. The surgery is usually successful, but about 15 percent of patients will still need some sort of drug therapy after the surgery. GERD can be a tough illness for older kids. The symptoms are unpleasant, and can make your child fill sad, anxious or "different" from other children. Fortunately, most kids with GERD can live active and healthy lives. With proper encouragement and parental support, and a well-organized and executed treatment plan, your child can successfully treat his or her GERD symptoms and minimize it's impact on his or her life. |
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