Gastroesophageal Reflux Disease  (GERD)

What is GERD?

Gastroesophageal reflux (GER) occurs when the stomach contents flow back into the esophagus. Most children and adults have GER every once in a while. It's also called heartburn or indigestion. Some babies may have GER often and then grow out of it. But when GER happens all the time, or causes other problems, it is called gastroesophageal reflux disease (GERD).

What are the signs and symptoms of GERD?

Some common symptoms of GERD in children include:

• Heartburn
• Chest pain
• Hiccups
• Irritability or crying often
• Regurgitation, food coming back into the mouth
• Choking or gagging
• Stomach pain after eating
• Vomiting or nausea
• Wheezing
• Bad breath
• Problems breathing
• Not gaining weight
• Bleeding in the digestive tract

What causes GERD?

GERD is often caused when the muscle at the lower end of the esophagus, called the lower esophageal sphincter (LES), relaxes too often or becomes weak. This allows stomach acid to flow to flow back into the esophagus. Babies are more likely to have a weak LES, but often grow out of it as they get older. Other things that can make children more likely to have GERD include:

• Having Down syndrome or developmental or neurological conditions, such as cerebral palsy
• Being overweight
• Being exposed to secondhand smoke
• Some medicines, including pain medicines, depressants and antihistamines

Some foods have also been linked to GER and GERD as they can make the LES stay open for too long. These foods include chocolate, peppermint and foods that are high in fat.

How is GERD treated?

Treatment for GERD in children depends on your child's age, symptoms, and the severity of the condition. Your care team at Arkansas Children's is experienced in treating GERD in children and will work with you to determine the best course of treatment for your child. Some options may include:

• Making diet and lifestyle changes. Some changes may include feeding your baby in an upright position, eating smaller portions, losing weight, and not going to bed after meals.
• Medicines. Your child’s doctor may suggest medicines to help reduce the amount of acid in the stomach or to help the stomach empty more quickly.
• Calorie supplements or tube feedings. If your baby can’t get enough calories because of GERD, your doctor may suggest one of these approaches to help them get the nutrition they need to grow.
• Surgery. In severe cases, your child may need surgery, called surgery called fundoplication, to create a tight band around the esophagus.