Gastroesophageal Reflux Disease—Adolescent
(GERD—Adolescent; Chronic Heartburn—Adolescent; Reflux Esophagitis—Adolescent; Gastro-oesophageal Reflux Disease—Adolescent; GORD—Adolescent; Heartburn—Adolescent; Reflux—Adolescent)
Pronounced: Gas-tro-ee-sof-a-geal re-flux
Gastroesophageal reflux disease (GERD) is a disorder that results from food and stomach acid backing up into the esophagus from the stomach. GERD is different from gastroesophageal reflux (GER). GER is a common disorder seen in infants, which causes them to spit up. Most infants outgrow GER within 12 months.
GERD can occur at any age and typically requires lifestyle changes, medications, and sometimes surgery. This condition can cause serious health issues. The sooner it is treated, the better the outcome.
Gastroesophageal Reflux Disease
Food travels down the esophagus to the stomach. The opening between the esophagus and stomach opens to let food enter the stomach. Normally, it closes as soon as the food enters the stomach. With heartburn, the opening does not close tightly. Stomach acid flows into the esophagus (called acid reflux), causing a burning sensation.
The following factors contribute to GERD:
- Abnormal pressure to the lower esophageal sphincter (LES), a valve that keeps food in the stomach
- Increased relaxation of LES
- Increased pressure within the abdomen
- Possibly a genetic link
Other causes include diseases that interfere with food passing through the esophagus or cause excess acid production.
Unlike infants and children, there are not many known risk factors for the development of GERD among adolescents. Obesity]]> , a risk factor for adults, may also increase the risk of developing this condition among teenagers. ]]>Smoking]]> and using ]]>alcohol]]> may also put teens at risk.
If your teen has any of these symptoms, do not assume it is due to GERD. These symptoms may be caused by other conditions. If your child has any of these, tell the doctor:
- Abdominal or chest pain
- Need to clear throat
- Bloody vomit
- Bad breath
- Difficulty swallowing
- Worsening asthma]]>
- Recurrent ]]>pneumonia]]> or respiratory problems
- Sore throat
- Cough, wheezing, or hoarseness
- Dental problems (due to the effect of the stomach acid on the tooth's enamel)
Your doctor will ask about your teen’s symptoms and medical history, and perform a physical exam. Your child may need to see a gastroenterologist, a doctor who specializes in gastrointestinal diseases.
Tests may include:
- Upper GI series]]> —a series of x-rays of the upper digestive system taken after drinking a barium solution
- ]]>Upper endoscopy]]> with biopsy—a tube is inserted into esophagus to look at the lining and a piece of tissue is taken for testing
- 24-hour pH monitoring—a probe is placed in the esophagus to keep track of the level of acidity in the lower esophagus
- Short trial of medicine
Talk with your doctor about the best treatment plan for you. Treatment options include the following:
Before recommending medication, your teen's doctor may suggest lifestyle changes. These may include:
- Eating smaller, more frequent meals
- Avoiding late night snacks
- Sleeping on the left side
Avoiding certain foods, such as:
- Fried foods
- Spicy foods
- Caffeine products
- Carbonated beverages
- Foods high in fat and acid
If your teen is obese, your doctor may recommend weight loss. Also, talk to your teen about smoking and alcohol, which can worsen GERD symptoms.
Medications may include:
- Histamine-2 receptor drugs—to decrease acid production (eg, Tagamet, Pepcid, Zantac)
- Proton pump inhibitors—to heal the esophagus lining and relieve symptoms (eg, Prilosec, Prevacid, Protonix, Nexium)
- Promotility drugs—to help slow stomach emptying (eg, Reglan)
- Over-the-counter antacids—to treat heartburn relief (eg, Tums, Maalox)
In severe cases, the doctor may recommend surgery. The most common treatment is called fundoplication]]> . During this procedure, the surgeon wraps part of the stomach around the lower esophageal sphincter. This makes the sphincter stronger and prevents stomach acid from backing up into the esophagus.
Children’s Digestive Health and Nutrition Foundation
National Digestive Diseases Information Clearinghouse (NDDIC)
About Kids Health
Canadian Digestive Health Foundation
Dente K. Quick lesson about gastroesophageal reflux disease in children and adolescents. EBSCO Nursing Reference Center website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=16topicID=860 . Accessed May 19, 2008.
Gastroesophageal reflux disease (GERD). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Accessed May 19, 2008.
Gastroesophageal reflux in children and adolescents. National Digestive Diseases Information Clearinghouse website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/gerinchildren/index.htm . Accessed May 19, 2008.
GERD in children and adolescents. Children’s Digestive Health and Nutrition Foundation website. Available at: http://gerd.cdhnf.org/User/Docs/PDF/AdolesGERDFlier.pdf . Accessed May 19, 2008.
GERD in children with an underlying structural anomaly. Children’s Digestive Health and Nutrition Foundation website. Available at: http://gerd.cdhnf.org/User/Docs/PDF/CUSA_Brochure.pdf . Accessed May 19, 2008.
Pediatric gastroesophageal reflux, clinical practice guideline summary. Children’s Digestive Health and Nutrition Foundation website. Available at: http://gerd.cdhnf.org/User/Docs/PDF/GERD_8_pg_brochure_031604.pdf . Accessed May 19, 2008.
Pediatric GE reflux clinical practice guidelines. J Pediatr Gastroenterol Nutr. 2001;32:S1-S31.
Last reviewed November 2008 by ]]>Daus Mahnke, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © 2007 EBSCO Publishing All rights reserved.