Acid reflux can strike any age group, and teenagers are no exception. It occurs when acidic stomach contents back up into the esophagus, causing symptoms like heartburn, stomach pain or cough. According to the 2013 "American Journal of Gastroenterology," 10 to 20 percent of adults have the chronic form of acid reflux, known as gastroesophageal reflux disease (GERD), but it is not known how many teenagers are affected. While many factors contribute to the occurrence of acid reflux, the lifestyle and dietary habits of American adolescents could certainly increase their risk.
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According to a September 2015 report from the Centers for Disease Control and Prevention, one-third of all children in 2011 to 2012 ate fast food daily, and adolescents aged 12 to 19 received an average of 16.9 percent of their calories from fast food. The high fat content in such fast-food favorites as cheeseburgers, fries and pizza is likely to aggravate acid reflux because fatty foods can stimulate stomach acid production. They also relax the band of muscle between the stomach and esophagus, called the lower esophageal sphincter (LES), that normally prevents stomach contents from refluxing back up. Other foods that may affect the LES and worsen reflux include spicy foods, citrus, mint and chocolate, another teenage favorite. The American College of Gastroenterology recommends that dietary changes be made on an individual basis, so teens with acid reflux should keep track of which foods trigger their heartburn and try eliminating those.
Caffeine, Tobacco and Alcohol
Caffeine can worsen acid reflux by causing the lower esophageal sphincter to relax. Teenagers may consume caffeine in the form of coffee, but energy drinks are especially popular. According to the March 2011 "Pediatrics," 30 to 50 percent of adolescents and young adults consume energy drinks, which may contain as much as 3 times the amount of caffeine as cola drinks. Additional caffeine may be present in additives, such as guarana, kola nut, yerba mate and cocoa, which may not be listed by the manufacturer. The carbonation of these drinks can also worsen reflux by filling the stomach with gas, putting additional pressure on the LES. As if there weren't enough other reasons not to smoke, teens should be aware that tobacco use can also make acid reflux worse, as can alcohol.
The Obesity Crisis and Acid Reflux
The obesity crisis in the United States has hit teens particularly hard. According to the CDC, from 1980 to 2012 the percentage of adolescents aged 12 to 19 years who were obese increased from 5 percent to nearly 21 percent. There is a strong link between obesity and acid reflux because excess weight can put pressure on the LES. This allows stomach acid and contents to back up into the esophagus, causing heartburn and other symptoms. According to the February 2013 "American Journal of Gastroenterology," studies have shown that weight loss reduces reflux symptoms in adults with obesity. For overweight and obese children and teens, the CDC recommends reducing the rate of weight gain while allowing normal growth and development. Because weight loss is thus a bit more complicated for teens than it is for adults, teens should only undertake a weight-loss diet under the supervision of a healthcare provider.
Diagnosis and Treatment
Acid reflux in teens is usually diagnosed upon review of symptoms and examination by a healthcare provider. Those who do not improve with therapy may undergo tests such as an endoscopy, in which a flexible tube with a camera takes pictures of the esophagus and stomach, or a 24-hour pH test, in which a tube is placed in the esophagus to detect acid reflux.
Acid reflux in teens is treated with a combination of lifestyle changes and medication therapy. In addition to dietary and weight interventions, for those with nighttime reflux symptoms, elevating the head of the bed with a foam wedge and avoiding meals 2 to 3 hours before bedtime may also help. Acid reflux in teens is also treated with medication, specifically the proton pump inhibitors, or PPIs. These medications, such as omeprazole (Prilosec) and lansoprazole (Prevacid), prevent stomach acid from being made. While they are available over the counter, for adolescents they should be prescribed by a healthcare provider.
It is important to seek treatment for acid reflux because, untreated, it can lead to serious complications, including Barrett esophagus -- a tissue abnormality associated with a risk for esophageal cancer, although it is rare in children.