Acid reflux is a common occurrence in infants and children, but when the symptoms worsen or occur more than twice a week, the child may suffer from gastroesophageal reflux disease, or GERD. In general, acid reflux is the flow of acidic stomach contents to the esophagus, the tube that connects the mouth to the stomach. If the symptoms of GERD are severe enough and not treated, it can cause significant health problems.
Causes
The main cause of acid reflux is weakness of the lower esophageal sphincter. This circular band of muscle surrounds the esophagus at the entrance of the stomach. It works by opening when food is going into the stomach and closing to prevent food from coming out. When the lower esophageal sphincter becomes weak, it does not close properly when food enters the stomach, resulting in the backflow of acid and stomach contents into the esophagus. According to the Merck Manual, other causes of acid reflux in children and infants include overfeeding, exposure to caffeine and food intolerance or allergies.
Symptoms
The symptoms of gastroesophageal reflux disease in infants include excessive spit-ups, irritability, crying inconsolably when offered a bottle and vomiting, which can have specks of blood. These symptoms impair the infant's ability to feed adequately, resulting in weight loss and poor growth. The pain of acid reflux also causes infants to have episodes of twisting and grimacing that resemble seizures. Older children may complain of chest or abdominal pain, foul taste in their mouth, vomiting and loss of appetite. If the reflux is severe enough to enter the lungs, children can have cough, wheezing and shortness of breath.
Medical Treatment
The medical treatment of reflux in infants begins with positioning the baby in an upright position while feeding small, frequents amounts of milk. According to the National Digestive Diseases Information Clearinghouse, over the counter and prescription medications can also be used to decrease the symptoms of reflux. These include H2 blockers that decrease acid production, proton-pump inhibitors that also reduce the secretion of acid and help heal the lining of the esophagus and prokinetics that strengthen the lower esophageal sphincter and speed up the emptying of the stomach.
Surgical Treatment
Infants and children who do not respond to medical treatment and continue to exhibit significant symptoms of GERD may need a surgery called Nissen fundoplication. In this surgery, the upper part of the stomach is wrapped around the lower esophageal sphincter to strengthen it and decrease acid reflux.
