These symptoms may include vomiting, gagging, coughing, and trouble breathing. These foods include: Chocolate Peppermint High-fat foods Other foods cause the stomach to make more acid. Each child may have different symptoms.
Common symptoms of GERD include: Burping or belching Not eating Having stomach pain Being fussy around mealtimes Vomiting often Having hiccups Gagging Choking Coughing often Having coughing fits at night Other symptoms may include: Wheezing Getting colds often Getting ear infections often Having a rattling in the chest Having a sore throat in the morning Having a sour taste in the mouth Having bad breath Loss or decay of tooth enamel GERD symptoms may seem like other health problems.
How is GERD diagnosed? Other tests may include: Chest X-ray. An X-ray can check for signs that stomach contents have moved into the lungs. This is called aspiration. Upper GI series or barium swallow. It checks the food pipe esophagus , the stomach, and the first part of the small intestine duodenum. Your child will swallow a metallic fluid called barium. Barium coats the organs so that they can be seen on an X-ray. Then X-rays are taken to check for signs of sores or ulcers, or abnormal blockages.
This test checks the inside of part of the digestive tract. It uses a small, flexible tube called an endoscope. It has a light and a camera lens at the end. Tissue samples from inside the digestive tract may also be taken for testing. Esophageal manometry. This test checks the strength of the esophagus muscles. It can see if your child has any problems with reflux or swallowing.
Then it measures the pressure that the esophageal muscles make at rest. This test checks the pH or acid level in the esophagus. The tube has a sensor that measures pH level. During this time your child can go home and do his or her normal activities. You will need to keep a diary of any symptoms your child feels that may be linked to reflux. These include gagging or coughing. You should also keep a record of the time, type of food, and amount of food your child eats. Gastric emptying study.
For babies: After feedings, hold your baby in an upright position for 30 minutes. If bottle-feeding, keep the nipple filled with milk. Try different nipples. Find one that lets your baby's mouth make a good seal with the nipple during feeding. Adding rice cereal to feeding may be helpful for some babies. Burp your baby a few times during bottle-feeding or breastfeeding. Your child may reflux more often when burping with a full stomach. For children: Watch your child's food intake.
Limit fried and fatty foods, peppermint, chocolate, drinks with caffeine such as sodas and tea, citrus fruit and juices, and tomato products. Offer your child smaller portions at mealtimes. Add small snacks between meals if your child is hungry. Let your child tell you when he or she is hungry or full. Serve the evening meal early, at least 3 hours before bedtime. Some may irritate the lining of the stomach or esophagus. This is for safety reasons and to reduce the risk for SIDS and other sleep-related infant deaths.
These medicines may include: H2-blockers. These reduce the amount of acid your stomach makes by blocking the hormone histamine. Histamine helps to make acid. Proton pump inhibitors. These help keep your stomach from making acid. They do this by stopping the stomach's acid pump from working. If this is the case, your child's healthcare provider may suggest: Adding rice cereal to baby formula Giving your baby more calories by adding a prescribed supplement Changing formula to milk- or soy-free formula if your baby may have an allergy Tube feedings.
It can last up to 2 hours and tends to be worse after meals and when lying down burping frequent hiccups frequent spitting up or vomiting, especially after meals the feeling of stomach acid coming up into the back of the throat acidic or bad breath frequent cavities, especially in the back teeth, despite good brushing Signs of GER in babies and young children include: choking or wheezing if the contents of the reflux get into the windpipe and lungs wet burps or wet hiccups spitting up that continues beyond a child's first birthday when it stops for most babies irritability or inconsolable crying after eating refusing to eat or eating only small amounts failure to gain weight Some of these symptoms may get worse if a baby lies down or is placed in a car seat after a meal.
What Causes Gastroesophageal Reflux? A steady reflux of stomach acid into the esophagus can lead to: breathing problems if the fluid enters the trachea, lungs, or nose redness and irritation in the esophagus, a condition called esophagitis bleeding in the esophagus scar tissue in the esophagus, which can make it hard to swallow pneumonia repeated asthma attacks Because these complications can make eating painful, GER can interfere with proper nutrition.
How Is Gastroesophageal Reflux Diagnosed? In younger children and babies, doctors might run these tests to diagnose GER or rule out other problems: Upper GI radiology study.
This special X-ray can show liquid backing into the esophagus, irritation or narrowing of the esophagus, and any upper digestive tract problems. For the test, your child will swallow a small amount of a chalky liquid barium. This liquid appears on the X-ray and shows the swallowing process. A thin, flexible tube goes through the nose into the esophagus. The tip rests just above the esophageal sphincter for 24 hours to check acid levels in the esophagus and to detect any reflux.
Milk scans. This series of X-ray scans tracks a special liquid as a child swallows it. The scans can show whether the stomach is slow to empty liquids and whether the refluxed liquid is being inhaled into the lungs. Upper endoscopy. Doctors look at the esophagus, stomach, and part of the small intestines using a tiny fiber-optic camera. They also may take a small tissue sample a biopsy of the lining of the esophagus to rule out or find other problems.
How Is Gastroesophageal Reflux Treated? Treatment for GER depends on the symptoms and how severe they are. Reflux is common in babies, and some simple feeding changes can help: Do not overfeed you baby.
Smaller, more frequent feedings can reduce reflux. Talk to your health care provider about how much and how often your baby should feed. Burp your baby before and after feeding. Hold the baby upright while feeding and for 15—30 minutes after. Do not put your baby in an infant seat after feeding. Often, these include: citrus fruits chocolate food and drinks with caffeine fatty and fried foods garlic and onions spicy foods tomato-based foods and sauces peppermint Doctors may recommend raising the head of an older child's bed 6 to 8 inches to help with reflux that happens at night.
Commonly-used tests include Upper GI series , which looks at the shape of your child's upper GI gastrointestinal tract. You child will drink a contrast liquid called barium. For young children, the barium is mixed in with a bottle or other food. The health care professional will take several x-rays of your child to track the barium as it goes through the esophagus and stomach. 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. The end of the tube in the esophagus measures when and how much acid comes back up into the esophagus.
The other end of the tube attaches to a monitor that records the measurements. Your child will wear the tube for 24 hours. He or she may need to stay in the hospital during the test. Upper gastrointestinal GI endoscopy and biopsy , which uses an endoscope, a long, flexible tube with a light and camera at the end of it. The doctor runs the endoscope down your child's esophagus, stomach, and first part of the small intestine.
While looking at the pictures from the endoscope, the doctor may also take tissue samples biopsy. What lifestyle changes can help treat my child's reflux or GERD? Sometimes reflux and GERD in children can be treated with lifestyle changes: Losing weight, if needed Eating smaller meals Avoiding high-fat foods Wearing loose-fitting clothing around the abdomen Staying upright for 3 hours after meals and not reclining and slouching when sitting Sleeping at a slight angle. Raise the head of your child's bed 6 to 8 inches by safely putting blocks under the bedposts.
What treatments might the doctor give for my child's GERD? They include Over-the-counter antacids H2 blockers, which decrease acid production Proton pump inhibitors PPIs , which lower the amount of acid the stomach makes Prokinetics, which help the stomach empty faster If these don't help and your child still has severe symptoms, then surgery might be an option.
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