Gastroesophageal Reflux Disea... Health Article

Causes

GERD is caused by a weakened or immature LES. It can also be caused by a hiatal hernia that traps the stomach contents. Having too much acid in the stomach can also weaken the LES.

Heredity plays a small part in whether a child has GERD. GERD seems to be more prone to occur in some families than others.

Other factors that seem to weaken the LES are allergies and neurological disorders that affect specific muscles in the body. Diabetes and rapid weight gain can also be factors in causing GERD.

Some medications also can weaken the LES. They include calcium channel blockers used to treat high blood pressure, theophyline used to treat asthma, and antihistamines. Nitrates in medications and foods can also trigger GERD.

In infants, it may simply be a matter of having an immature digestive system. Once the body begins to mature, the GERD goes away. For adolescents, the hormones of puberty seem to trigger acid reflux.

Certain foods have been known to affect the muscle tone of the LES and increase stomach acids. Chocolate, peppermint, and high fat foods can allow the LES to relax and stay open more often. Citrus foods, tomatoes, and tomato products increase acid production in the stomach.

Lifestyle habits can also trigger episodes of acid reflux. Using caffeine and alcohol, smoking, eating large meals, and having poor posture can produce GERD.

Symptoms

Though heartburn is the characteristic symptom of GERD in adolescents and adults, GERD in children and infants is not so easy to recognize. Frequent vomiting or spitting up is the usual indicator for GERD in children. However, vomiting can be a symptom of many other childhood disorders, including stomach flu, allergy, or a related symptom to almost any illness. Frequent vomiting that continues after the first four months of life or is excessive at any time usually indicates the presence of GERD. Constant crying with back arching usually accompanies the frequent vomiting.

Children with GERD who are preschool age and older often have gas and abdominal pain above the navel. They only have intermittent vomiting. They can also experience chest pain or true heartburn symptoms, which can last up to two hours and get worse after eating. Bending over or lying down makes the heartburn worse.

Children with GERD exhibit difference symptoms. They can either gain or lose weight. One group of children will eat more because they are uncomfortable and a full stomach seems to make them feel better temporarily. Another group of children are often very picky about what they eat, refusing specific foods. These children will only eat a few bites even though they might be very hungry. A third group of children report having trouble swallowing; they choke or gag whenever they eat, no matter what foods are served. A fourth group of children will drink liquids constantly because doing so soothes the burning feeling in their esophagus.

Respiratory symptoms are twice as likely to occur in children with GERD as those who do not have it. Children often have frequent sore throats when they wake up in the morning, sinus infections, bronchitis, and dry coughs. These children have a constantly runny nose or a hoarse, deep voice. They can also experience wheezing or other asthma symptoms. Some children aspirate the stomach contents, which can cause pneumonia or even sudden death.

Sleep is often disturbed. Children often wake up with a nighttime cough or choke when they lie down. Some children experience sleep apnea (interrupted breathing).

Other children have frequent ear infections or drool a lot. Some infants and toddlers will insist on being held upright and not laid down, often falling asleep over a parent's shoulder or in a parent's arms. In some extreme cases, when there is a lot of stomach acid regurgitation, the child's teeth will show enamel erosion.

Children with GERD may also have hiccups or belch a lot. They can also have bad breath and complain of having a sour taste in their mouths.

Some children with GERD have anemia. This condition usually develops because there is an ulcer in the lining of the esophagus that has begun to bleed.

When to call the doctor

It is important to call the doctor if GERD symptoms occur frequently or get worse. If symptoms disturb the child's sleep and interfere with school and play, a doctor should be consulted to determine a course of treatment. Also, if a child is not eating or gaining weight or has breathing difficulty, parents should seek medical advice as soon as possible. For a child of any age, if blood is present in vomit, a doctor should be called. If a child over two complains of swallowing difficulty, a serious condition could exist and a doctor should be called.