Patient education: Acid reflux and GERD in children and teens (The Basics)

What is acid reflux? — Acid reflux is when the food or acid that is normally in the stomach backs up into the esophagus (figure 1). The esophagus is the tube that carries food from the mouth to the stomach.

A small amount of acid reflux is normal. But if it happens frequently, it can cause problems with the esophagus or lung infections (pneumonia). When acid reflux causes bothersome symptoms or damage, doctors call it "gastroesophageal reflux disease," or "GERD."

Children with certain health issues have a higher risk of GERD. These include children with Down syndrome, cerebral palsy, or other problems with the brain or spinal cord. Children who are overweight also are more likely to have GERD.

What are the symptoms of acid reflux? — The symptoms depend on the child's age.

Preschool children with acid reflux might:

●Vomit

●Taste stomach acid in the mouth, or feel it in the throat

●Not want to eat

●Lose weight

Older children or teens with acid reflux might:

●Taste stomach acid in the mouth, or feel it in the throat

●Have an upset stomach

●Feel burning in the chest (known as "heartburn")

●Have trouble swallowing

Having symptoms like these once in a while is normal. If any of these symptoms happen more than once a week, this might be a sign of GERD.

Will my child need tests? — Maybe. If you think your child might have acid reflux, talk to their doctor or nurse before you try any treatments. They can suggest ways to help relieve symptoms. They might also do tests to figure out if your child's symptoms are caused by reflux or something else.

Is there anything I can do to help my child feel better? — Yes. There are some things that might help with acid reflux, depending on your child's age and symptoms. Children and teens might feel better if they:

●Avoid foods that make symptoms worse – These might include chocolate, peppermint, caffeine, and fatty foods. Teens should also avoid alcohol.

●Raise the head of their bed by 6 to 8 inches – You can do this by putting blocks of wood or rubber under 2 legs of the bed or a foam wedge under the mattress. If your child is a baby, do not raise the head of their crib or bed. Also, babies should always sleep on their back.

●Lose weight, if they are overweight – Ask your child's doctor or nurse for advice on how to do this safely.

●Avoid being around cigarette smoke. Teens should also avoid smoking and vaping.

●Avoid late meals – Lying down with a full stomach can make reflux worse. Try to plan meals for at least 2 to 3 hours before bedtime.

●Chew gum, or suck on lozenges – This can sometimes help with symptoms in older children and teens.

●Avoid tight clothing – Some people have less acid reflux if they wear comfortable clothing that does not squeeze the stomach area.

How is acid reflux treated? — Sometimes, acid reflux symptoms can be treated with medicines. Talk to your child's doctor or nurse before you give your child any medicines for reflux.

There are 3 main types of medicines that can help: antacids, histamine blockers, and proton pump inhibitors (table 1). All of these medicines work by reducing or blocking stomach acid. But they each do that in a different way:

●Antacids can relieve mild symptoms, but they work only for a short time. You can buy them without a prescription. It is not safe to give more than a few doses of antacids to children younger than 5 years. Older children should not take antacids for more than a few days at a time.

●Histamine blockers are stronger and last longer than antacids. You can also buy most histamine blockers without a prescription.

●Proton pump inhibitors are the most effective medicines for treating GERD. You can buy some of these medicines without a prescription. But there are other versions that your child's doctor or nurse can prescribe.

If your child's doctor or nurse recommends a medicine, they will usually suggest that your child try the medicine for a few weeks first. Then, if symptoms do not get better, they might suggest stopping the medicine, trying a different medicine, or doing tests.

A few children need surgery to treat their GERD. This is more likely in children who have a problem with the brain or spinal cord (such as cerebral palsy), and if the GERD is causing problems like pneumonia.

When should I call the doctor? — Your child should see a doctor or nurse right away if they:

●Have trouble swallowing, or feel as though food gets "stuck" on the way down

●Lose weight

●Have chest pain

●Choke when they eat

●Vomit blood

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