What causes GERD?
GERD is often the result of conditions that affect the lower esophageal sphincter (LES). The LES, a muscle located at the bottom of the esophagus, 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 refluxes back into the esophagus, causing vomiting or heartburn.
Everyone has gastroesophageal reflux from time to time. If you have ever burped and had an acid taste in your mouth, you have had reflux. The lower esophageal sphincter occasionally relaxes at inopportune times, and usually, all your child will experience is a bad taste in the mouth, or a mild, momentary feeling of heartburn.
Infants are more likely to experience weakness of the lower esophageal sphincter (LES), causing it to relax when it should remain shut. As food or milk is digesting, the LES opens and allows the stomach contents to go back up the esophagus. Sometimes, the stomach contents go all the way up the esophagus and the infant or child vomits. Other times, the stomach contents only go part of the way up the esophagus, causing heartburn, breathing problems, or, possibly, no symptoms at all.
Some foods seem to affect the muscle tone of the lower esophageal sphincter, allowing it to stay open longer than normal. These include, but are not limited to, the following:
- High-fat foods
Other foods increase acid production in the stomach, including:
- Citrus foods
- Tomatoes and tomato sauces
Why is GERD a concern?
Some infants and children who have GER may not vomit, but may still have stomach contents move up the esophagus and spill over into the windpipe (the trachea), which can cause asthma and/or pneumonia.
Infants and children with GERD who vomit frequently may not gain weight and grow normally. Inflammation (esophagitis) or ulcers (sores) can form in the esophagus due to contact with stomach acid. These can be painful and also may bleed, leading to anemia (too few red blood cells in the bloodstream). Esophageal narrowing (stricture) and Barrett's esophagus (abnormal cells in the esophageal lining) are long-term complications from inflammation that are seen in adults.
What are the symptoms of GERD?
Heartburn, also called acid indigestion, is the most common symptom of GERD. Heartburn is described as a burning chest pain that begins behind the breastbone and moves upward to the neck and throat. It can last as long as two hours and is often worse after eating. Lying down or bending over after a meal can also contribute to heartburn. Most children younger than 12 years of age who are diagnosed with GERD will experience a dry cough, asthma symptoms, or trouble swallowing, instead of classic heartburn.
The following are other common symptoms of GERD. However, each child may experience symptoms differently. Symptoms may include:
- Refusal to eat
- Fussiness around mealtimes
- Frequent vomiting
- Frequent cough
- Coughing fits at night
- Frequent upper respiratory infections (colds)
- Frequent ear infections
- Rattling in the chest
- Frequent sore throat in the morning
- Sour taste in the mouth
The symptoms of GERD may resemble other conditions or medical problems. Consult your child's doctor for a diagnosis.