Heartburn: Not Just for Adults—Kids Get It Too

girl holiding cupcake Your family has just finished dinner when someone at the table starts feeling a burning sensation in their chest. It is not your spouse or Aunt Mabel, but your child. The burning sensation, or heartburn, is one symptom of gastroesophageal reflux disease (GERD).

GERD happens when acid and food flow back up from the stomach and into the esophagus (the tube that connects the mouth to the stomach), potentially damaging the esophagus. GERD can cause chronic problems, such as regurgitation or respiratory problems.

Although symptoms are similar, this is not to be confused with gastroesphageal reflux (GER). GER is common in infants and children. It eventually goes away on its own without treatment.

According to a study in The American Journal of Gastroenterology, children with GERD may be at risk for having this condition as an adult, as well. Fortunately, researchers say that detecting and treating GERD during childhood may result in better outcomes later in life.

What Causes GERD?

GERD is caused by the weakening of a muscle called the lower esophageal sphincter (LES). When you swallow, it contracts to prevent stomach contents from flowing back up, or regurgitating, into the esophagus. Certain foods, medications, and conditions can relax the LES, allowing acid to regurgitate. It may also occur as a result of impaired or absent muscle tone.

If your child has GERD, the doctor may recommend avoiding:

  • Spicy, acidic, or tomato-based foods
  • Fatty or fried foods
  • Citrus products, such as orange juice
  • Chocolate
  • Caffeinated drinks, such as soda, coffee, tea, or hot chocolate

Teenagers should also avoid smoking cigarettes and drinking alcohol, and those with GERD have an added incentive not to. These activities can worsen their symptoms.

What Are the Symptoms?

Symptoms of GERD in children include:

  • Severe abdominal discomfort
  • Lower chest pain
  • Heartburn
  • Sensation of food or liquid regurgitating into the throat or mouth
  • Sensation of food stuck down in the throat
  • Difficulty or pain while swallowing
  • Hoarseness
  • Vomiting
  • Poor weight gain or weight loss
  • Anemia
  • Respiratory problems, such as wheezing, coughing, or pneumonia

GERD can cause other health complications for your child that occur over a long period of time. These include:

  • Esophagitis—an inflammation of the esophagus
  • Stricture—a narrowing of the esophagus that may make swallowing difficult

To help your child communicate how they are feeling and to better understand the symptoms, ask your child the following questions:

  1. Where does your tummy hurt? (Ask your child to point to where it hurts.)
  2. Does it hurt in your chest?
  3. Does it hurt when you eat or drink?
  4. Do you get a yucky or sour taste in your mouth? Does it taste like throw-up?
  5. Does food sometimes get stuck in your throat?

What Are the Treatment Options?

GERD can usually be diagnosed based on your child’s symptoms and a physical exam. Additional diagnostic tests are often not required. Once the diagnosis is made, it can be treated through lifestyle changes, medications, and rarely, surgery.

Lifestyle Changes

The first step is changing your child’s diet. This may relieve mild symptoms. Avoiding GERD “trigger” foods may be the first step. The doctor may also suggest feeding your child smaller meals and avoiding food 2-3 hours before bedtime. The doctor may also suggest that you elevate the head of your child's bed 6-8 inches (15-20 centimeters) or have your child sleep on the left side.

Medication

Medications prescribed to treat GERD in children decrease the amount of acid produced in the stomach. These include H2-blockers and proton pump inhibitors (PPIs).

Surgery

Surgery, such as a procedure called fundoplication, is rarely used to treat children with GERD. Rather, it is reserved for severe cases or when medications and lifestyle changes do not relieve symptoms.

Take Action Now

GERD can be an uncomfortable condition for both you and your child. But, there is help available. Recognizing and relieving symptoms now may benefit your child's health down the line.

  • Children’s Digestive Health and Nutrition Foundation

    http://www.cdhnf.org

  • International Foundation for Functional Gastrointestinal Disorders

    http://www.aboutgerd.org

  • The Canadian Association of Gastroenterology

    http://www.cag-acg.org

  • Dietitians of Canada

    http://www.dietitians.ca

  • El-Serag HB, Gilger M, Carter J, et al. Childhood GERD is a risk factor for GERD in adolescents and young adults. Am J Gastroenterol. 2004;99(5):806-812.

  • Gastroesophageal reflux. Nemour's Kids Health website. Available at: http://kidshealth.org/parent/system/surgical/gerd%5Freflux.html. Updated June 2011. Accessed September 25, 2013.

  • Gastroesophageal reflux disease (GERD) in infants. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed.ebscohost.com/about/about-us. Updated June 22, 2012. Accessed September 25, 2013.

  • Gastroesophageal reflux in children and adolescents. National Digestive Diseases Information Clearinghouse, National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/gerinchildren. Updated September 5, 2013. Accessed September 25, 2013.

  • Gold BD. Gastroesophageal reflux disease: could intervention in childhood reduce the risk of later complications? Am J Med. 2004;117(Suppl 5A):23S-29S.

  • Gold BD, Freston JW. Gastroesophageal reflux in children: pathogenesis, prevalence, diagnosis, and role of proton pump inhibitors in treatment. Pediatr Drugs. 2002;4:673-685.

  • Hassall E. Decisions in diagnosing and managing chronic gastroesophageal reflux disease in children. J Pediatr. 2005;146(Suppl 3):S3-12.

  • Jung AD. Gastroesophageal reflux in infants and children. Am Fam Physician. 2001 Dec 1;64:1853-1860.

  • Lightdale JR, Gremse DA, et al. Gastroesophageal reflux: management guidance for the pediatrician. Pediatrics. 2013;131(5):e1684-1695.

  • Nielsen RG, Bindsley-Jensen C, Kruse-Andersen S, et al. Severe gastroesophageal reflux disease and cow milk hypersensitivity in infants and children: disease association and evaluation of a new challenge procedure. J Pediatr Gastroenterol Nutr. 2004;39(4):383-391.