What is GERD?

Gastroesophageal Reflux Disease (GERD) is a backup of food and digestive acids from the stomach into the esophagus (digestive tube that leads from the mouth to the stomach).  The stomach contents are normally held down in the stomach by a thick muscular ring called the “Lower esophageal sphincter” (LES).  If the sphincter relaxes  then stomach acids are then able to flow backwards into the esophagus, causing irritation and symptoms.

In Pediatrics, GERD is often seen in babies under the age of 12 months, when the LES has lower tone.  This can lead to frequent regurgitation and fussiness.  GERD can present in school aged children as well,  With children diet, genetics and other factors can play a role in the development of GERD.

 


What are the symptoms of GERD?

  • Heartburn/ Chest pain
  • Vomiting
  • Difficulty swallowing
  • Nausea
  • Sour taste in the throat
  • Dental erosions
  • Chronic sore throat, hoarseness
  • Chronic cough


How is GERD diagnosed?

Generally doctors are able to diagnose GERD with a good patient history. Occasionally,  other tests will be required to make the diagnosis when the history is not as clear. They may include:

  • Upper GI/Barium Swallow: This test uses barium, a chalky white liquid which is swallowed by the patient while a special series of X-rays is taken. This test is often used to identify other abnormalities in anatomy that may explain symptoms.
  • Endoscopy. This is a test performed by a specialist who inserts a small tube with a lighted camera.  The camera can help visualize abnormalities of the lining of the esophagus, stomach and even part of the small intestine and guide the specialist to take tissue samples of abnormal appearing areas.
  • Gastric emptying study. Occasionally this test is performed to determine if there is delay in emptying of the stomach which contributes to GERD. The patient swallows food or drink mixed with a radioactive material which is photographed and timed as it travels through the GI.

How is GERD Treated?

If your pediatrician diagnoses your child with reflux he or she may be placed on medication, most of which reduce the production of acid by the stomach.

You also may be asked to modify the diet to avoid food that aggravate GERD. Diet modification is very important in getting control of symptoms of GERD. Triggers for GERD can to some extent vary from patient to patient.  Below is a list of common triggers known to aggravate symptoms. Some of these foods may worsen symptoms because they are too acidic or irritating to the lower esophagus. Others may actually cause relaxation of the lower esophageal sphincter, therefore causing acid to splash up into the esophagus. Once GERD symptoms are under good control you may talk to your doctor about adding back some of these foods in moderation.

FOODS TO AVOID WITH GERD


OTHER GERD TRIGGERS

  • Stress: Try reducing stress with activities that make you feel happy.
  • Large meals: Avoid large meals and instead eat frequent smaller meals.
  • Eating before bedtime: Eating stimulates acid production, and laying down may bring that acid up into the lower esophagus, aggrevating symptoms.  Do not eat for about 2 hours before bedtime.  Elevating the head of the bed may help as well.
  • Tight fitting clothing: Wear loose fitting clothing that does not put extra pressure on the abdomen.
  • Obesity: Weight loss can help alleviate symptoms.  Many foods that cause weight gain also worsen symptoms of GERD.  By avoiding GERD triggers, patients may also lose weight.
  • Smoking: Smoking cessation can lead to improved symptoms.

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