Pediatrics - GERD
A ring of muscles is located at the bottom of the esophagus. It is called the lower esophageal sphincter (LES). The LES opens to allow food to enter the stomach. The LES closes tightly after the food enters. This prevents stomach contents and acids from entering the esophagus.
The stomach produces acids to break down food for digestion. The stomach secretes mucus to protect the lining of the stomach from the acids. The esophagus does not secrete mucus and is not protected from stomach acids.
GERD can occur during pregnancy. The LES may not close tightly during pregnancy because of the relaxing effects of hormones and increased abdominal pressure. Other medical conditions associated with GERD include diabetes, obesity, scleroderma, and hiatal hernia. Additionally, certain medications that relax the LES may contribute to GERD.
Finally, poor eating habits can contribute to GERD. Overeating, eating large meals, and eating before bedtime or lying down can cause food to back up from the stomach into the esophagus. Some foods are especially irritating. These include fatty and fried foods; chocolate; garlic and onions; beverages or food containing caffeine; spicy foods; foods high in acid, such as tomatoes and citrus fruits; and candy or food containing mint flavorings.
Certain lung problems may occur with GERD. Your child may experience difficulty with breathing. Your child may cough or wheeze. GERD can contribute to asthma and worsen the symptoms of asthma in people who already have it.
Am I at Risk
Is My Child at Risk?
Risk factors may increase your child’s likelihood of developing GERD. People with all of the risk factors may never develop the condition; however, the chance of developing GERD increases with the more risk factors your child has. You should tell your doctor about your child’s risk factors and discuss your concerns.
Risk factors for GERD:
_____ Being overweight or obese can increase abdominal pressure causing food to back up into the esophagus.
_____ The hormones produced during pregnancy can relax the LES. The hormones can also relax the muscles in the esophagus and cause food to move more slowly. Additionally, abdominal pressure during pregnancy can cause food to back up into the esophagus.
_____ Cigarette smoking is an irritant. The nicotine from tobacco relaxes the LES. Cigarette smoking can also reduce the amount of saliva produced. A lack of saliva can make the esophagus lining more sensitive to the stomach acids. It can also cause heartburn to be more severe.
_____ Drinking alcohol increases the likelihood that stomach acids will back up into the esophagus.
_____ Eating certain foods can relax the LES. Such foods include chocolate, caffeine products, fatty foods, greasy foods, spicy foods, citrus products, tomato-based foods, mints, or mint flavored foods.
_____ Certain medications can aggravate reflux in some people. Over-the-counter medications include aspirin and ibuprofen. This also includes certain prescription medications for asthma, emphysema, and osteoporosis.
_____ Older adults have an increased risk because the esophagus muscles can weaken with age. The esophagus may lose its wave pattern or have weak inconsistent contractions.
_____ Scleroderma increases the risk of developing GERD. Scleroderma is a rare autoimmune disease in which a person’s immune system destroys healthy tissues.
_____ A hiatal hernia increases the risk of developing GERD. A hiatal hernia occurs when a part of the stomach protrudes through the muscles and into the chest wall. A major symptom of a hiatal hernia is the back flow of stomach acid into the esophagus.
Research trials are focusing on new surgery methods. The research trials will determine if the new surgery methods are safe and effective treatments for GERD. These include the Stretta Radiofrequency Procedure, EndoCinch Procedure, and Enteryx Injections. The Stretta Radiofrequency Procedure involves using radiofrequency delivered through the endoscope to tighten the LES. The EndoCinch Procedure uses an endoscopic sewing device to place sutures to correct the LES. Enteryx Injections are delivered by the endoscope. Enteryx is a medication that forms a spongy mass in the esophagus and reinforces the LES to prevent the back flow of stomach acid.
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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.
The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on April 13th, 2016. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.