When stomach acid moves in the wrong direction, splashing up the esophagus toward the throat and mouth, it is called acid reflux. Acid reflux that persists and causes problems is called acid reflux disease. Children with acid reflux disease may have the same symptoms as adults, like burning upper abdominal or middle chest pain, or a sour taste in the mouth. However, a child's age seems to correlate with which symptoms he is most likely to report. Despite these age-related differences, reflux-associated nausea, laryngitis, sinusitis and pneumonia can be seen in children of all ages.
Heartburn and Regurgitation
What an adult may quickly label as heartburn translates to different behaviors and descriptions in children. Poor weight gain and food refusal can be seen in toddler and preschool aged children. Younger children, ages 3 to 9 years old, reported upper abdominal pain as their most common symptom, according to a study in the February 2000 edition of "JAMA Pediatrics." In contrast, children ages 10 to 17 years identified a sour taste in their mouth as their most common symptom from acid reflux. Recurrent vomiting, trouble gaining weight and difficulty swallowing are less common but can also be symptoms of acid reflux in children.
Sinusitis and Laryngitis
As with adults, sometimes reflux affects areas beyond the esophagus -- up in the head and neck -- in children. The larynx is the part of the throat with the vocal cords, so refluxed acid there can cause inflammation and a hoarse voice, as well as cough and sore throat. Sinus inflammation may produce symptoms of facial pressure or pain, headache and a feeling of nasal stuffiness. Children with acid reflux disease have inflammation of the sinus cavities and the larynx much more often than their healthy peers, according to a study published in the March 2001 issue of "Gastroenterology."
Pneumonia and Asthma
Recurrent episodes of pneumonia can also be a sign of acid reflux disease in children. Stomach acid that comes back up into the esophagus and reaches the throat can end up in delicate structures of the lungs, irritating the tissue and making infection more likely. Acid reflux that affects the airways can promote inflammation and restriction associated with asthma that may be hard to control. If a child with asthma also has acid reflux disease, it may be making her asthma symptoms worse, causing more nighttime symptoms or the need for steroids to control symptoms.
There are lots of ways acid reflux disease can present in a child, and children may experience and report their symptoms differently than adults. Some presentations of reflux are obvious, and some are not. If your child has ongoing complaints of heartburn or a sour taste in the mouth, trouble gaining weight, difficult-to-control asthma, or recurrent vomiting, throat pain or pneumonia, bring him to see his doctor. A physician can advise you on the need for tests to diagnose the condition and explain potential treatments to ease the symptoms your child is experiencing.
Medical advisor: Jonathan E. Aviv, M.D., FACS
- Journal of Pediatric Gastroenterology and Nutrition: Pediatric Gastroesophageal Reflux Clinical Practice Guidelines
- JAMA Pediatrics: Prevalence of Symptoms of Gastroesophageal Reflux During Childhood
- Pediatrics: Gastroesophageal Reflux: Management Guidance for the Pediatrician
- Gastroenterology: Extraesophageal Associations of Gastroesophageal Reflux Disease in Children Without Neurologic Defects