In many cases, children with GERD who are younger than 12 don’t have heartburn. The National Institutes of Health report that research is underway to explore the root causes of gastroesophageal reflux disease.
GERD (gastroesophageal reflux disease) is a more serious and long-term type of reflux. In babies and children with GERD, the sphincter muscle is developed but weak, relaxing to allow food to flow back into the esophagus. Gastroesophageal reflux disease (GERD) is a digestive condition in which the stomach’s contents often come back up into the food pipe. Dietary changes can help to ease symptoms.
There is a genetic predisposition favoring the first-born male. Diagnostic evaluation includes abdominal ultrasound or barium swallow (see below).
Gastric emptying study. A test designed to determine if the stomach releases its contents into the small intestine properly. Delayed gastric emptying can contribute to reflux into the esophagus. Esophageal manometric study. A test that helps determine the strength of the muscles in the esophagus.
Over time, babies with reflux may not gain weight as expected (failure to thrive) and may have frequent chest infections due to aspirating (breathing in) stomach contents into the windpipe and lungs. The inside surface of the oesophagus may become inflamed due to contact with stomach acid, which may lead to scarring and narrowing. In some children, however, the reflux continues. This is caused by a combination of factors which may include a wider than usual opening in the diaphragm around the oesophagus and a weakened sphincter.
When GER becomes GERD
Your doctor will want to check you on a regular basis in order to detect any cancer in its early stages. People who have Barrett’s esophagus may require periodic endoscopies with esophagus biopsies to check for pre-cancer cells (dysplasia). heart attack. Sometimes medical professionals diagnose GERD after evaluating a patient for episodes of chest pain that are found to be unrelated to heart disease.
Gastroenterology Research and Practice
Use medication temporarily as you work with your doctor to make changes to the diet to help resolve heartburn in your child for good. 23. DiMarino MC. Drug treatment of gastric acidity. Merck Manual Professional Version. www.merckmanuals.com/professional/gastrointestinal-disorders/gastritis-and-peptic-ulcer-disease/drug-treatment-of-gastric-acidity#section_7.
In this procedure, the child is checked into the hospital overnight and a very thin tube is threaded through his nose down to the base of his esophagus. Over the next 24 hours, the test measures the frequency and severity of reflux episodes as well as the child’s breathing and heart rate.
GER may occur in both breastfed and/or formula fed infants. Several studies document that breast fed infants empty their stomach faster than formula fed infants and are thus less likely to experience GER symptoms.
While rare, studies may be necessary either to establish/support the diagnosis of GERD or to determine the extent of damage caused by the repeated reflux events. The diagnosis of GER is based upon characteristic historical facts reported by the infant’s parents coupled with an elimination of pathological conditions by a normal physical exam. It is very rare to need laboratory studies to establish or support the diagnosis. Part of the evaluation of an infant who may have GER is to rule out pyloric stenosis. Pyloric stenosis is the thickening of the region of the stomach (pyloris) as it transitions into the first section of the small intestine.
Treatment options during infancy:
The symptoms of GERD may resemble other conditions or medical problems. Consult your child’s doctor for a diagnosis. During infancy, the prognosis for gastroesophageal reflux resolution is excellent (although developmental disabilities represent an important diagnostic exception); most patients respond to conservative, nonpharmacologic treatment. Laryngeal tissues are exquisitely sensitive to the noxious effect of acid, and studies support a significant relationship between laryngeal inflammatory disease (manifested by hoarseness, stridor, or both) and gastroesophageal reflux.
GERD also refers to the array of medical complications, some serious, that can arise from this reflux. Surgical management of GERD typically becomes necessary in presence of GER complications and/or failed medical therapy. It is considered for the patient with esophagitis, stricture, pulmonary symptoms such as asthma and recurrent pneumonia, and finally those with failure or inadequate response to medical therapy associated with neurologic handicaps [18, 19].
A pediatric gastroenterologist, a doctor who treats children who have digestive diseases, would do the surgery. Esophageal pH and impedance monitoring, which measures the amount of acid or liquid in your child’s esophagus. A doctor or nurse places a thin flexible tube through your child’s nose into the stomach.