The stomach secretes acid to help digest the foods we eat, but when stomach acid makes its way into the esophagus, the tube that connects the mouth to the stomach, children can exhibit symptoms of gastroesophageal reflux disease, or GERD. If untreated, severe gastroesophageal reflux disease can cause feeding difficulty and affect a child's growth and development.
Causes
The main reason for acid to flow from the stomach back into the esophagus and cause GERD is weakness of the lower esophageal sphincter. According to the National Digestive Diseases Information Clearinghouse, the lower esophageal sphincter is a round band of muscle that surrounds the esophagus at its entrance to the stomach. It opens to let food in and closes to prevent food from leaving the stomach. Children with GERD have weakness of the lower esophageal sphincter, which prevents it from closing completely and allows acidic stomach contents to flow back into the esophagus.
Symptoms
Infants and babies normally have episodes of spitting up milk or formula, but if they have GERD, they usually have frequent episodes of vomiting, with milk occasionally coming out of their nose as well. They will have difficulty breathing and coughing and choking episodes. These symptoms can lead to irritability, aversion to taking milk, weight loss and poor growth. Older children might have the typical heartburn symptoms of GERD, or might regurgitate food, have a sour taste in the mouth, and experience breathing problems and vomiting, which can contain specks of blood.
Treatment
The initial treatment of GERD in children is avoidance of foods that could increase the stomach's acidity, such as citric fruits, chocolate, foods with caffeine and spicy foods. According to the Nemours Foundation, babies' symptoms can improve by thickening the milk with rice cereal and holding the baby in an upright position while feeding. Medicine to treat GERD in children includes H-2 blockers, which block the production of acid, and proton-pump inhibitors, which are more effective at decreasing the acid content at the same time they heal the esophagus form the inflammation caused by GERD.
Surgery
Infants and babies who do not respond to medical treatment and continue to exhibit severe symptoms, including poor weight gain, might benefit from reflux surgery. The procedure, called a Nissen fundoplication, involves wrapping the upper portion of the stomach around the lower esophageal sphincter. This procedure tightens the sphincter in a way that prevents GERD while at the same time allowing for continued feeding.
