Gastroesophageal reflux disease (GERD) is a disorder that results in food and stomach acid backing up into the esophagus from the stomach. GERD requires treatment to avoid complications, such as esophageal damage.
Gastroesophageal Reflux Disease
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The lower esophageal sphincter (LES) is a muscular ring between the esophagus and the stomach. It relaxes to let food pass into the stomach, then closes shut to prevent it from backing up. With GERD, the ring doesn't close as tightly as it normally should. This causes acid reflux, a burning sensation that can be felt below the breastbone.
The following factors contribute to GERD: Problems with the nerves that control the LESProblems with LES muscle toneImpaired peristalsis—muscular contractions that propel food toward the stomachAbnormal pressure on the LESIncreased relaxation of the LESIncreased pressure within the abdomen
Factors that may increase your teen's chance of GERD include: ObesitySmokingAlcohol useHistory of a herniaNeurological impairments
GERD may cause: Chronic heartburn—most common symptomRegurgitationAbdominal or chest painVomitingDifficulty swallowingDry coughHoarsenessSore throat
asthmaWeight loss, lack of appetite
Your doctor will ask about your teen’s symptoms and medical history. A physical exam will be done.
Tests may include: 24-hour pH monitoring—a probe is placed in the esophagus to keep track of the acid in the lower esophagusShort trial of medications—success or failure of medication may help your doctor understand the cause
Imaging tests can assess LES function and surrounding structures. These may include: Upper GI seriesUpper endoscopy
Treatment options vary based on the severity of the GERD. Options may include one or more of the following:
This may be all that is needed to relieve GERD symptoms. In some cases, these may be recommended before medication is prescribed. These changes can be tailored to an individual person based on their habits. Lifestyle changes include: Eating smaller, more frequent meals.Avoiding overeating.Avoiding late night meals.Sleeping with the head of the bed elevated.Avoiding lying down within 2-3 hours after eating.Wearing looser clothing that doesn't bind the stomach area.Losing weight if needed.Quitting smoking.
Foods and drinks to avoid may include: ChocolateFried foodsPeppermintSpicy foodsCaffeine productsCarbonated drinksFoods high in fat and acidAlcohol
Medication may be needed to relieve symptoms and heal any damage to the esophagus. Many medications for GERD are available over-the-counter and by prescription.
Your teen's doctor may recommend the following: AntacidsH-2 blockersProton pump inhibitors
In more severe cases, the doctor may recommend surgery or endoscopy.
The most common surgery is called
fundoplication. During this procedure, the surgeon wraps part of the stomach around the LES. This makes the LES stronger and prevents stomach acid from backing up into the esophagus.
There are no current guidelines to prevent GERD.
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http://www.ebscohost.com/dynamed. Updated April 29, 2013. Accessed April 30, 2013.
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http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/ger-and-gerd-in-children-and-adolescents/Pages/facts.aspx. Updated February 21, 2012. Accessed April 30, 2013.
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.
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J Pediatr Gastroenterol Nutr.
3/1/2010 DynaMed's Systematic Literature Surveillance
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http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm200672.htm. Published February 17, 2010. Accessed April 30, 2013.
1/20/2015 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: National Institute for Health and Care Excellence. Gastro-oesophageal reflux disease: recognition, diagnosis and management in children and young people. January 2015. Available at: https://www.nice.org.uk/guidance/ng1. Accessed January 20, 2015.
Last reviewed February 2015 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.
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