Gastroesophageal Reflux in Children and Adolescents

On this page:

• What is gastroesophageal reflux (GER)? 
• What are the symptoms of GER? 
• How is GER diagnosed? 
• What is the treatment for GER? 
• Points to Remember 
• Hope through Research 
• For More Information 

What is gastroesophageal reflux (GER)?

Gastroesophageal reflux occurs when stomach contents reflux, or back up, into the esophagus during or after a meal. The esophagus is the tube that connects the mouth to the stomach. A ring of muscle at the bottom of the esophagus opens and closes to allow food to enter the stomach. This ring of muscle is called the lower esophageal sphincter (LES). Reflux can occur when the LES opens, allowing stomach contents and acid to come back up into the esophagus.

GER often begins in infancy, but only a small number of infants continue to have GER as older children.

What are the symptoms of GER?

Almost all children and adults have a little bit of reflux, often without being aware of it. When refluxed material rapidly returns to the stomach, it does not harm the esophagus. However, in some children, the stomach contents remain in the esophagus and damage the esophageal lining. In other children, the stomach contents go up to the mouth and are swallowed again. When the refluxed material passes into the back of the mouth or enters the airways, the child may become hoarse, have a raspy voice, or a chronic cough. Other symptoms include

• recurrent pneumonia
• wheezing
• difficult or painful swallowing
• vomiting
• sore throat
• weight loss
• heartburn (in older children)

How is GER diagnosed?

You may want to visit an internist or a gastroenterologist. An internist specializes in internal medicine and a gastroenterologist treats diseases of the digestive system. The doctor can talk with you about your child’s symptoms, examine your child, and recommend tests to determine if reflux is the cause of the symptoms. These tests check the esophagus, stomach, and small intestine for problems. Sometimes a doctor will start treatment without running tests if the symptoms strongly indicate GER.

The most common tests used to diagnose GER are the following:

• Upper gastrointestinal (GI) series x ray. X rays are taken to check for damage to the esophagus, stomach, or intestines. First, a chalky drink called barium is swallowed, which makes the images on the x rays easier to see. A doctor cannot make a diagnosis of GER based on x rays alone, but x rays help rule out other problems that cause the same symptoms as GER.