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Gastroesophageal reflux (GER) is a digestive disorder. Gastroesophageal refers to the stomach and esophagus. The esophagus is the tube that connects the throat to the stomach. Reflux means to flow back or return.
In this condition, the acidic stomach juices, food, and fluids come back into your child’s esophagus.
Reflux can happen at any age, but it’s common in babies. It may be a temporary condition. It can also become a long-term problem. This is called gastroesophageal reflux disease (GERD).
Reflux is often caused by problems with the lower esophageal sphincter (LES). This is a muscle at the bottom of the esophagus. Normally, it opens to let food into the stomach and closes to keep food in the stomach. When this muscle relaxes too often or for too long, acid goes back into the esophagus. This causes nausea, vomiting, and heartburn.
As babies digest their food, the LES may open. This lets stomach contents go back up into your child’s esophagus. Sometimes the contents go all the way up. This causes your baby to vomit. Other times, the contents may only go part of the way up the esophagus. This can cause heartburn or breathing problems. Or it may not cause symptoms.
Symptoms can occur a bit differently in each child. They can include:
The symptoms of this condition may be similar to symptoms of other health problems. Make sure your child sees his or her healthcare provider for a diagnosis.
Your child’s healthcare provider will check his or her health history. Then he or she will give your child an exam. Your child’s healthcare provider may do the following tests to diagnose GER.
A chest X-ray is done to look for signs of aspiration. In this condition, the stomach contents spill into the lungs. This causes breathing problems and lung infections.
An upper GI series looks at the organs in the upper part of your child’s digestive system. These include the esophagus, stomach, and the first section of the small intestine (duodenum). For this test, your child will swallow barium. This is a metallic liquid that coats the inside of his or her organs. This helps them show up on an X-ray. Then your child’s healthcare provider will take an X-ray of these organs.
In this test, a small, flexible tube (endoscope) is used to look at the inside of your child’s digestive tract. This tube has a light and a camera lens at the end of it. During the test, your child may have tissue samples removed from his or her digestive tract. Your child’s healthcare provider will test these samples.
This test measures the level of acidity in your child’s esophagus.
This test will show if your child’s stomach contents empty into his or her small intestine the right way. Delayed gastric emptying can cause reflux.
Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.
Most babies with reflux have no symptoms other than spitting up often. As long as these children grow well and don’t have other issues caused by reflux, they don’t need treatment.
Sometimes reflux can be managed with feeding changes. These changes should be made under the care of your baby's healthcare provider . These can include:
Your baby may need reflux medicine. These medicines can decrease the amount of acid the stomach makes. This will ease the heartburn caused by reflux.
Some babies with reflux may vomit often. This can keep them from gaining weight. In this case, your baby’s healthcare provider may suggest the following:
Some babies with reflux have other conditions that make them tired. These can include heart disease or being born premature. These babies may not be able to eat much before getting sleepy. Other babies can’t keep a normal amount of formula or breastmilk in their stomachs without vomiting. These babies may do better if they took in a small amount of food continuously.
In these cases, your child’s healthcare provider may recommend tube feedings. A tube is placed in your child’s nose and guided through the esophagus and stomach. This is called a nasogastric tube. These tubes can also be used to bypass the stomach if needed. Tube feedings can be done with or in place of bottle-feeding or breastfeeding.
In severe cases, your child will need surgery. This surgery is done to reinforce the lower esophageal sphincter. This helps keep the reflux from happening.
Some babies with reflux may not vomit. Instead, their stomach contents may move up and spill over into the windpipe (trachea). This can cause wheezing and pneumonia. In rare cases, this can be life-threatening.
Babies with reflux who vomit often may not gain weight and grow normally. This can cause inflammation (esophagitis) or sores (ulcers) in the esophagus. These ulcers can be painful. They may also bleed. This can lead to anemia. This means too few red blood cells in the bloodstream. Over time, this may cause long-term problems. These can include the conditions esophageal narrowing (stricture) and abnormal cells in the lining of the esophagus (Barrett's esophagus).
Many babies with reflux will outgrow it by the time they are 1 year old. This is when the LES becomes stronger. For other babies, feeding and lifestyle changes and medicine can help. Work with your child’s healthcare team to create a care plan for your child.
Call your child’s healthcare provider if your child vomits after every feeding or has new reflux symptoms.
Tips to help you get the most from a visit to your child’s healthcare provider:
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