Symptoms
Almost all children and adults have a little bit of reflux, without being aware of it. When refluxed material rapidly returns to the stomach, it causes no damage to the esophagus. In some children, the stomach contents remain in the esophagus and cause damage to the esophagus lining. In other children, the stomach contents go up to the mouth (regurgitation) and are swallowed again. When the refluxed material passes into the back of the mouth or enters the airways, the child may become hoarse or have a raspy voice or a chronic cough. Other symptoms include recurrent pneumonia, wheezing, and difficult or painful swallowing.
Treatment
The treatment of reflux depends on the child's symptoms and age. When a child or teenager is uncomfortable, has difficulty sleeping or eating, or fails to grow, the doctor or nurse may first suggest a trial of medication to decrease the amount of acid made in the stomach. One class of medications called H2-blockers includes cimetidine (Tagamet), ranitidine (Zantac), famotidine (Pepcid), and nizatidine (Axid). Another class is proton-pump inhibitors such as esomeprazole (Nexium), omeprazole (Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex), and pantoprazole (Protonix).*
* The authors of this fact sheet do not specifically endorse the use of drugs for children that have not been tested in children ("off label" use). Such a determination can only be made under the recommendation of the treating health care provider.
If the child continues to have symptoms despite the initial treatment, tests may be ordered to help find better treatments. It is rare for children to require surgery for GER. However, surgery may be the best option for children who have severe symptoms that do not respond to any treatment.
Your child's doctor or nurse can discuss the treatment options with you and help your child feel well again.
Additional suggestions are
- Have your child or teenager eat smaller meals more often.
- Avoid eating 2 to 3 hours before bed.
- Elevate the head of the bed 30 degrees.
- Avoid carbonated drinks, chocolate, caffeine, and foods that are high in fat or contain a lot of acid (citrus fruits) or spices.
For additional information: Gastroesophageal Reflux in Children and Adolescents
