Heartburn: Not Just for Adults—Kids Get It Too
Your family has just finished dinner when someone at the table starts feeling a burning sensation in their chest. It is not your spouse or Aunt Mabel, but your child. The burning sensation, or heartburn, is one symptom of gastroesophageal reflux disease (GERD).
GERD is the back-up of acid and food from the stomach into the esophagus (the tube that connects the mouth to the stomach). Acid can potentially damage the esophagus. GERD can also cause chronic problems, such as regurgitation or respiratory problems.
Although symptoms are similar, this is not to be confused with gastroesophageal reflux (GER). GER is common in infants and children. It eventually goes away on its own without treatment.
GERD in childhood can also increase the risk of having this condition as an adult. Fortunately, detecting and treating GERD during childhood may result in better outcomes later in life.
What Causes GERD?
GERD is caused by the weakening of a muscle called the lower esophageal sphincter (LES). When you swallow, it contracts to prevent stomach contents from flowing back up, or regurgitating, into the esophagus. Certain foods, medications, and conditions can relax the LES, allowing acid to regurgitate. It may also occur as a result of impaired or absent muscle tone.
If your child has GERD, the doctor may recommend avoiding:
- Spicy, acidic, or tomato-based foods
- Fatty or fried foods
- Citrus products, such as orange juice
- Caffeinated drinks, such as soda, coffee, tea, or hot chocolate
Teenagers should also avoid smoking cigarettes and drinking alcohol, and those with GERD have an added incentive not to. These activities can worsen their symptoms.
What Are the Symptoms?
Symptoms of GERD in children include:
- Severe abdominal discomfort
- Lower chest pain
- Sensation of food or liquid regurgitating into the throat or mouth
- Sensation of food stuck down in the throat
- Difficulty or pain while swallowing
- Poor weight gain or weight loss
- Respiratory problems, such as wheezing, coughing, or pneumonia
GERD can cause other health complications for your child that occur over a long period of time. These include:
- Esophagitis—an inflammation of the esophagus
- Stricture—a narrowing of the esophagus that may make swallowing difficult
To help your child communicate how they are feeling and to better understand the symptoms, ask your child the following questions:
- Where does your tummy hurt? (Ask your child to point to where it hurts.)
- Does it hurt in your chest?
- Does it hurt when you eat or drink?
- Do you get a yucky or sour taste in your mouth? Does it taste like throw-up?
- Does food sometimes get stuck in your throat?
What Are the Treatment Options?
GERD can usually be diagnosed based on your child’s symptoms and a physical exam. Additional diagnostic tests are often not required. Once the diagnosis is made, it can be treated through lifestyle changes, medications, and rarely, surgery.
The first step is changing your child’s diet. This may relieve mild symptoms. Avoiding GERD “trigger” foods may be the first step. The doctor may also suggest feeding your child smaller meals and avoiding food 2-3 hours before bedtime. The doctor may also suggest that you elevate the head of your child's bed 6-8 inches (15-20 centimeters) or have your child sleep on the left side.
Medications prescribed to treat GERD in children decrease the amount of acid produced in the stomach. These include H2 blockers and proton pump inhibitors (PPIs).
Surgery, such as a procedure called fundoplication, is rarely used to treat children with GERD. Rather, it is reserved for severe cases or when medications and lifestyle changes do not relieve symptoms.
Take Action Now
GERD can be an uncomfortable condition for both you and your child, but it is treatable. Recognizing and relieving symptoms now may benefit your child's health down the line.
International Foundation for Functional Gastrointestinal Disorders
North American Society for Pediatric Gastroenterology, Hepatology and Nutrition
Canadian Association of Gastroenterology
Dietitians of Canada
Acid reflux (GER &GERD) in children and teens. National Digestive Diseases Information Clearinghouse, National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-children-teens. Accessed May 4, 2017.
Baird DC, Harker J, Karmes AS. Diagnosis and treatment of gastroesophageal reflux in infants and children. Am Fam Physician. 2015;92(8):705-717.
Gastroesophageal reflux. Kids Health—Nemours Foundation website. Available at: http://kidshealth.org/en/parents/gerd-reflux.html. Updated January 2015. Accessed May 4, 2017.
Gastroesophageal reflux disease (GERD) in infants. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T116575/Gastroesophageal-reflux-disease-GERD-in-infants. Updated April 21, 2016. Accessed May 4, 2017.
GERD in children and adolescents. North American Society for Pediatric Gastroenterology, Hepatology and Nutrition website. Available at: http://www.naspghan.org/files/documents/pdfs/medical-resources/gerd/Adolescents%20and%20GERD_FlyerFormat.pdf. Accessed May 4, 2017.
Last reviewed May 2017 by Michael Woods, MD, FAAP Last Updated: 5/4/2017