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Gastro-esophageal reflux disease (GERD) is present when partly digested food comes up from the stomach into the tube that links the mouth to the 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. 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.¹

Babies and young children are more likely to GERD if:²

• 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 esophageal sphincter doesn't close properly for other reasons.
• 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 inflamed. This is called esophagitis.

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 2008. All rights reserved.