Gastroesophageal reflux (GER) and gastroesophageal reflux disease (GERD) are common conditions.
GER is a condition where the contents of the stomach come back up into the esophagus (food pipe). This occurs when the circular muscle at the top of the stomach (known as the lower esophageal sphincter) relaxes and creates an opening. The lower esophageal sphincter is located at the junction of the esophagus and the stomach. The sphincter relaxes when a child eats to allow food in and when a child needs to belch. In people with GER, this muscle ring also relaxes at other times. Most people experience some amount of GER. When GER becomes excessive and results in complications it is called GERD.
Symptoms of GER vary and depend on a child's age.
It is not concerning for infants to have episodes of spitting up as long as:
Most infants outgrow GER by the age of 12 to 18 months; improvement may be noted when the infant starts to sit, stand or walk and when solid foods are begun at 6 months of age.
In older children, from toddler age to adolescents, symptoms of GER and GERD may include:
In older children, obesity can be a cause of GER/GERD.
If your older child experiences these symptoms, a pediatric gastroenterologist can perform a physical exam and additional tests to make a diagnosis, assess the severity of the problem and establish associated complications. Tests include:
Treatment of GER and GERD depends on the age of the child and severity of the condition.
Uncomplicated GER in infants often resolves on its own or with simple behavioral changes and does not require medicine. Acid suppressing medications can increase the chance for pneumonia and gastrointestinal infections and are not routinely recommended for children under 6 months of age.
In older children and adolescents, a pediatric gastroenterologist may advise behavioral and dietary changes. Foods known to make reflux worse include:
The most common things suspected to make reflux worse include:
Your child can improve his or her symptoms by avoiding these foods and behaviors.
Children with GER disease may require medicines to treat their symptoms. Types of medicines prescribed to treat GERD include:
If medicines do not ease symptoms and promote healing, a pediatric gastroenterologist may discuss surgical options.
Visit the websites below to find support groups and services and learn more about GER.
Riley at IU Health offers a broad range of supportive services to make life better for families who choose us for their children's care.
This website from the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition explains the differences between GERD in infants and GERD in older children and offers resources and checklists to help manage the condition.
The pediatric gastroenterologists at Riley at IU Health participate in clinical research to advance the understanding of esophageal diseases, including GERD. You and your child may be offered participation in our research studies. These studies may help improve our care of children with similar problems. We encourage you to ask plenty of questions in order to make an informed decision.
In addition to our primary hospital location at the Academic Health Center in Indianapolis, IN, we have convenient locations to better serve our communities throughout the state.
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