Gastroesophageal reflux (GER) occurs when a small amount of acidic stomach fluid or food in the stomach goes back up into the esophagus (swallowing tube). This is a normal process with symptoms including regurgitation or pain that can be experienced several times a day, especially after eating, and usually lasting less than three minutes. Some individuals with GER will have no symptoms. GER occurs in more than two-thirds of healthy infants, and half of these infants experience regurgitation or “spitting up” that spontaneously resolves without medication by approximately 1 year of age. A pediatrician or gastroenterologist should evaluate children whose symptoms worsen or do not resolve by the time they are 12-18 months of age.
When to see a doctor
When the reflux causes intolerable discomfort or complications, patients should be evaluated by a doctor for gastroesophageal reflux disease (GERD). GERD in infants is treated with a lifestyle modification approach. Children and adolescents can also be treated with medicine. In rare cases, surgery may be needed.
If you think your child may have GER or GERD, discuss it with your pediatrician. He or she may recommend lifestyle modifications:
- For infants
- Change in milk formulation
- Hold your infant in an upright position after feedings
- Avoid placing your infant in a car seat after a meal
- For children and adolescents
- Avoid large meals
- Do not lie down immediately after eating
- If obese or overweight, lose weight
- Avoid foods and drinks that can cause acid reflux, such as garlic, peppermint, caffeine, tomatoes, chocolate, citrus fruits, alcohol and spicy foods
Doctors may prescribe medications that lower the amount of acid in the stomach to alleviate symptoms of GERD:
- Tums (calcium carbonate)
- Milk of Magnesia (magnesium hydroxide)
- Pepcid (famotidine)
- Zantac (ranitidine)
- Prilosec (omeprazole)
- Prevacid (lansoprazole)
- Nexium (esomeprazole)
- Aciphex (raberprazole)
Remember to always consult your child’s pediatrician, gastroenterologist or pharmacist before starting any medication.
Warning signs or symptoms that immediately require further medical evaluation:
- Weight loss
- Abdominal distention
- Green or red vomit
- Persistent forceful vomit
It can be helpful to keep a diary of GERD symptoms. Record your child’s symptoms and bring the diary to doctors’ appointments. This information can help the doctor determine what is causing GERD symptoms and provide better care for your child.