Gastroesophageal reflux happens when food and stomach acid flow from the stomach back into the esophagus. The esophagus is the tube that carries food from the mouth to the stomach. In adults, reflux is often called heartburn or acid reflux.
Reflux is common in babies and children, and it is usually not a sign of a serious problem. Most babies stop having reflux around 1 year of age. A child who continues to have reflux may need treatment.
Reflux happens because of a problem with the ring of muscle at the end of the esophagus. The ring of muscle is called the lower esophageal sphincter, or LES. The LES acts like a one-way valve between the esophagus and the stomach. When you swallow, it lets food pass into the stomach. If the LES is weak, stomach contents can flow back up into the esophagus.
In babies, this problem happens because the digestive tract is still growing. Reflux usually goes away as a baby matures.
It is common for babies to spit up (have reflux) after they eat. Babies with severe reflux may cry, act fussy, or have trouble eating. They may not sleep well or grow as expected.
An older child or teen may have the same symptoms as an adult. He or she may cough a lot and have a burning feeling in the chest and throat (heartburn). He or she may have a sour or bitter taste in the mouth.
If stomach acid goes up to the throat or into the airways, a child may get hoarse or have a lasting cough. Reflux can also cause pneumonia or wheezing, and it may hurt to swallow.
To find out if a child has reflux, a doctor will do a physical examination and ask about symptoms. A baby who is healthy and growing may not need any tests. If a teen is having symptoms, the doctor may want to see if medicines help before doing tests.
If a baby is not growing as expected or treatment doesn't help a teen, the doctor may want to do tests to help find the cause of the problem. Common tests include:
Most babies stop having reflux over time, so the doctor may just suggest that you follow some steps to help reduce the problem until it goes away. For example, it may help to:
For older children and teens, it may help to:
If these steps don't work, the doctor may suggest medicine. Medicines that may be used include:
Before you give your child any over-the-counter medicine for reflux:
Children with reflux rarely need surgery. It may be an option for babies or children who have severe reflux that causes breathing problems or keeps them from growing.
Other Works Consulted
Hoffenberg E, et al. (2014). Gastrointestinal tract. In WW Hay Jr et al., eds., Current Diagnosis and Treatment: Pediatrics, 22nd ed., pp. 651–691. New York: McGraw-Hill.
Horvath A, et al. (2008). The effect of thickened-feed interventions on gastroesophageal reflux in infants: Systematic review and meta-analysis of randomized, controlled trials. Pediatrics, 122(6): e1268–e1277.
Khan S, Orenstein SR (2011). Gastroesophageal reflux disease. In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 19th ed., pp. 1266–1270. Philadelphia: Saunders.
Orenstein SR, et al. (2009). Multicenter, double-blind, randomized, placebo-controlled trial assessing the efficacy and safety of proton pump inhibitor lansoprazole in infants with symptoms of gastroesophageal reflux disease. Journal of Pediatrics, 154(4): 514–520.
ByHealthwise StaffPrimary Medical ReviewerJohn Pope, MD - PediatricsBrian D. O'Brien, MD - Internal MedicineAdam Husney, MD - Family MedicineE. Gregory Thompson, MD - Internal MedicineKathleen Romito, MD - Family MedicineSpecialist Medical ReviewerChuck Norlin, MD - PediatricsArvydas D. Vanagunas, MD - Gastroenterology
Current as ofFebruary 27, 2017
Current as of: February 27, 2017
John Pope, MD - Pediatrics
& Brian D. O'Brien, MD - Internal Medicine & Adam Husney, MD - Family Medicine & E. Gregory Thompson, MD - Internal Medicine & Kathleen Romito, MD - Family Medicine & Chuck Norlin, MD - Pediatrics & Arvydas D. Vanagunas, MD - Gastroenterology
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