Gastroesophageal Reflux Disease—Adolescent
(GERD—Adolescent; Chronic Heartburn—Adolescent; Reflux Esophagitis—Adolescent; Gastro-oesophageal Reflux Disease—Adolescent; GORD—Adolescent; Reflux—Adolescent)
See also:
Definition
Gastroesophageal reflux disease (GERD) results in food and stomach acid backing up into the esophagus from the stomach. GERD requires treatment to avoid complications like esophageal damage.
Causes
The lower esophageal sphincter (LES) is a muscular ring between the esophagus and the stomach. It relaxes to let food pass into the stomach, then closes shut to prevent it from backing up. With GERD, the ring does not close as tightly as it normally should. This causes acid reflux, a burning sensation that can be felt below the breastbone.
The following factors contribute to GERD:
- Problems with the nerves that control the LES
- Problems with LES muscle tone
- Impaired peristalsis—muscular contractions that propel food toward the stomach
- Abnormal pressure on the LES
- Increased relaxation of the LES
- Increased pressure within the abdomen
Risk Factors
Factors that may increase your teen's chance of GERD include:
Symptoms
GERD may cause:
- Chronic heartburn—most common symptom
- Regurgitation
- Abdominal or chest pain
- Vomiting
- Difficulty swallowing
- Dry cough
- Hoarseness
- Sore throat
- Recurrent aspiration pneumonia or worsening asthma
- Weight loss, lack of appetite
Diagnosis
Your doctor will ask about your teen’s symptoms and medical history. A physical exam will be done.
Tests may include:
- 24-hour pH monitoring—a probe is placed in the esophagus to keep track of the acid in the lower esophagus
- Short trial of medications—success or failure of medication may help your doctor understand the cause
Imaging tests can assess LES function and surrounding structures. These may include:
- Upper GI series —x-rays using contrast material that is swallowed
- Upper endoscopy with biopsy
Treatment
Treatment options vary based on the severity of the GERD. Options may include one or more of the following:
Lifestyle Changes
This may be all that is needed to relieve GERD symptoms. In some cases, these may be recommended before medication is prescribed. These changes can be tailored to an individual person based on their habits. Lifestyle changes include:
- Eating smaller, more frequent meals.
- Avoiding overeating.
- Avoiding late night meals.
- Sleeping with the head of the bed elevated.
- Avoiding lying down within 2-3 hours after eating.
- Wearing looser clothing that doesn't bind the stomach area.
- Losing weight if needed.
- Quitting smoking.
Foods and drinks to avoid may include:
- Chocolate
- Fried foods
- Peppermint
- Spicy foods
- Caffeine products
- Carbonated drinks
- Foods high in fat and acid
- Alcohol
Medications
Medication may be needed to relieve symptoms and heal any damage to the esophagus. Many medications for GERD are available over-the-counter and by prescription. Your teen's doctor may recommend the following:
- Antacids
- H2 blockers
- Proton pump inhibitors
Procedures
In more severe cases, the doctor may recommend surgery or endoscopy.
The most common surgery is called fundoplication. During this procedure, the surgeon wraps part of the stomach around the LES. This makes the LES stronger and prevents stomach acid from backing up into the esophagus.
Prevention
There are no current guidelines to prevent GERD.
RESOURCES:
NASPGHAN—North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition
https://www.naspghan.org
National Institute of Diabetes and Digestive and Kidney Diseases
https://www.niddk.nih.gov
CANADIAN RESOURCES:
About Kids Health—The Hospital for Sick Children
http://www.aboutkidshealth.ca
Canadian Digestive Health Foundation
http://www.cdhf.ca
REFERENCES:
Acid reflux (GER & GERD) in children & teens. National Institute of Diabetes and Digestive and Kidney Disorders website. Available at: https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-children-teens. Accessed January 28, 2021.
Gastroesophageal reflux disease (GERD). EBSCO DynaMed website. Available at: http://www.dynamed.com/topics/dmp~AN~T116914/Gastroesophageal-reflux-disease-GERD. Accessed January 28, 2021.
Gastroesophageal reflux disease (GERD). Kids Health—Nemours Foundation website. Available at: http://kidshealth.org/en/teens/gerd.html. Accessed January 28, 2021.
Last reviewed March 2020 by EBSCO Medical Review Board Chelsea Skucek, MSN, BS, RNC-NIC Last Updated: 1/28/2021