What is Reflux in children?

Reflux in children

What is GERD?

If your child has gastro-esophageal reflux disease (GERD), they bring up partly digested food from their stomach into the tube that links their mouth and stomach. The tube is called the esophagus. Sometimes food can come all the way up into the throat or mouth and the child may vomit ('throw up').

A ring of muscle at the lower end of the esophagus, where it joins the stomach, usually prevents food from being brought back up (regurgitated). The muscle is called the lower esophageal sphincter. It acts like a

valve
A valve is a piece of tissue, located in a tube or passageway in your body, that keeps materials or fluid flowing in one direction, by preventing them from flowing backward. There are valves in your veins, for example, which keep blood flowing towards the heart, and stop blood from flowing back away from the heart.

valve. When you eat, the muscle opens up so that food can go from your esophagus into your stomach. The muscle then closes up so that the food stays in the stomach until it is broken down and moves into the gut.

In babies and young children, this muscle may not work properly. So they sometimes bring up their food, and may vomit. In many children, there's nothing wrong with the muscle, and we don't fully understand why it opens when it shouldn't.

Source:
Rudolph CD, Mazur LJ, Liptak GS, et al.
Guidelines for evaluation and treatment of gastroesophageal reflux in infants and children: recommendations of the North American Society for Pediatric Gastroenterology and Nutrition.
Journal of Pediatrics and Gastroenterology and Nutrition 2001; 32 (supplement 2): S1-S31.

GERD can be worrying, but most of the time it's not a serious problem. Children normally grow out of it.

Source:
Craig WR, Hanlon-Dearman A, Sinclair C, et al.
Metoclopramide, thickened feedings, and positioning for gastro-oesophageal reflux in children under two years (Cochrane review).
In: The Cochrane Library. Wiley, Chichester, UK.

Babies and young children are more likely to GERD if:

Source:
Herbst JJ.
Textbook of gastroenterology and nutrition in infancy. 2nd edition.
Raven Press, New York, U.S.A.; 1989.

The ring of muscle at the bottom of the esophagus (the esophageal sphincter) hasn't fully developed. This is more likely in premature babies.
The stomach gets too full.
Part of the stomach gets pushed up into the chest, through a gap in the diaphragm (a large, thin muscle that separates the lungs and the stomach). This is called a hiatus hernia. If this happens, your child may need an operation to close the gap.
Food moves too slowly down the esophagus.

When partly digested food goes up into the esophagus, it is often quite acidic. This is because acid is produced in the stomach to help break food down, before it moves into the gut. If acid gets into the esophagus it can make it sore and

inflammation
If your skin or some other part of your body becomes red, swollen, hot or sore, we say it is inflamed. It means that your body is trying to protect you from germs, from something in your body tissues that can hurt you (like a thorn or sliver), or from things that cause allergies (allergens). Inflammation is part of the way the body heals an infection or injury.

inflamed. This is called esophagitis.

Sources for the information on this page:

Rudolph CD, Mazur LJ, Liptak GS, et al.Guidelines for evaluation and treatment of gastroesophageal reflux in infants and children: recommendations of the North American Society for Pediatric Gastroenterology and Nutrition.Journal of Pediatrics and Gastroenterology and Nutrition 2001; 32 (supplement 2): S1-S31.

Craig WR, Hanlon-Dearman A, Sinclair C, et al.Metoclopramide, thickened feedings, and positioning for gastro-oesophageal reflux in children under two years (Cochrane review).In: The Cochrane Library. Wiley, Chichester, UK.

Herbst JJ.Textbook of gastroenterology and nutrition in infancy. 2nd edition.Raven Press, New York, U.S.A.; 1989.

This information was last updated on Nov 06, 2008

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment.
© BMJ Publishing Group Limited 2009. All rights reserved.

The information on ConsumerReportsHealth.org should not be viewed as a substitute for a consultation with a medical or health professional. The information is meant to enhance communication with your doctor, not replace it. Consumers Union can not be liable for any loss, injury, or other damages related to your use of this information.

Your use of this information is subject to our User Agreement available at www.ConsumerReportsHealth.org.