Acid Reflux (GERD) in Children

A well-balanced diet and nutrition are crucial for your child’s optimal growth and development. However, if your child consistently refuses to eat, experiences frequent vomiting, complains of stomach aches, exhibits recurrent sore throats, or displays other similar symptoms, then it is something to worry about. There is a possibility that your child may be grappling with acid reflux, also known as gastroesophageal reflux disease (GERD). So, what is GERD? This condition occurs when the stomach’s contents, including acidic digestive juices, flow back up into the oesophagus, causing discomfort and a range of unpleasant symptoms. To effectively manage GERD in your child and alleviate their distress, it is essential to understand the causes, symptoms, and treatment options available for acid reflux in kids.

What Is Acid Reflux?

Acid reflux, or gastroesophageal reflux disease (GERD), is a digestive ailment that may affect babies and children equally. In most cases, this problem may get better by the time your child turns three years old. However, some children may keep battling with it for a longer period, and this may affect the growth of the child, and cause harm to the oesophagus.

How Common Is It in Children?

Acid reflux in children is not uncommon, and it can affect children of various ages, from infants to teenagers. In infants, it’s often referred to as gastroesophageal reflux (GER) or infant reflux, and it typically resolves on its own as the child grows. In older children, it can still occur but may be less common than in infants.

The prevalence of acid reflux in children can vary, but it’s estimated that around 5-10% of infants and children may experience symptoms of acid reflux at some point. If you suspect your child has acid reflux, it’s important to consult a healthcare professional for proper evaluation and management.

What Causes Gastroesophageal Reflux in Children?

You may wonder why your child is suffering from this problem. Most babies develop this condition due to an immature digestive system, but in older babies and children, this is due to a weaker and lower oesophagal sphincter or LES. Following are some reasons or causes of lower LES in children:

• Taking certain medications (for example, painkillers, and antihistamines to treat asthma)
• More pressure on the abdominal region because of excessive weight or by engaging in strenuous physical activity
• Developmental or neurological disorders
• Any kind of abnormality in the stomach, which may cause acid to run back to the oesophagus
• Consuming spicy and heavy meals and then lying on the back or bending down from the waist
• Consuming food with high acidic content
• Eating meals just before going to bed or late at night

What Are the Symptoms of Acid Reflux in Kids?

Here’s a list of GERD symptoms in kids. If your child is complaining or exhibiting any of these symptoms, you should consult your doctor:

• Foul smell from your child’s mouth or bad breath
• Feelings of nausea or vomiting after consuming meals
• Constant refusal to eat
• Experiences of pain or difficulty in swallowing food
• Choking or wheezing sound when the food enters your child’s windpipe
• Complaint by your child of a sour taste in his mouth, usually after waking up in the mornings
• Experiencing constant bouts of heartburn, and burning sensation in the stomach, or complaints of pain in the chest by your child

All these above-mentioned symptoms are indicative of the fact that your child may be suffering from gastroesophageal reflux disease. Therefore, you should seek medical help for the same, and get your child’s symptoms under control.

How to Diagnose GERD in a Child?

In case your child is of the age where he can talk about his problem with the doctor, then the doctor will ask various questions to your kid, do a physical examination, and ask about various other symptoms, too. All this information will help the doctor decide the correct course of treatment for your kid. However, if your baby or younger child is the victim of this problem, then your doctor may conduct the following examination to confirm the diagnosis:

1. Milk Scans: Milk scan or gastric emptying study involves adopting X-ray techniques to monitor the liquid in the child’s stomach. This test helps establish if the liquid is getting inhaled into the lungs, or stomach is acting slowly in emptying the liquid.
2. Upper GI Test or Barium Test: This is a test that shows how the oesophagus reacts to barium. It helps in detecting any abnormalities or irritation in the oesophagus.
3. pH Probe Or 24-hour Impedance-Probe Study: This is an invasive technique in which a thin flexible tube inserted through the nose into the oesophagus to check acid levels.
4. Upper GI Endoscopy: In this procedure, a tiny camera is used to see directly into the oesophagus, stomach, and the small intestine to check for the probable cause of acid reflux.

Possible Complications of Paediatric GERD

GERD or gastroesophageal reflux disease may sometimes cause serious complications in children. Following are some of the complications that may arise:

• It may cause breathing problems in children. This may happen when the stomach’s contents enter the trachea, nose, or lungs of the child.
• Sometimes GERD may cause bleeding in the oesophagus.
• Some children may develop esophagitis, a condition resulting from irritation and redness of the oesophagus.
• In some cases, children may develop scar tissue in the oesophagus. This may make swallowing extremely difficult for the child.

Treatment for GERD in Kids

If your child is suffering from gastroesophageal reflux disease, your doctor may advise you various acid reflux treatments for the child, with options based on the severity and symptoms of your child’s condition. Here are some of the treatment options available to treat gastroesophageal reflux disease in children:

• The doctor may prescribe antacids to stop acid formation.
• The doctor may give Proton pump inhibitors such as Prevacid and Nexium.
• The doctor may prescribe Histamine-2 blockers, which reduce the formation of acid.

Apart from the above medicines, your doctor may recommend the following changes in your child’s diet and lifestyle to reduce the symptoms of GERD:

• Avoiding fatty, starchy or fried food items
• Refraining from acidic fruits and vegetables, carbonated beverages and other such food items that irritate the tummy
• Eating smaller and more frequent meals throughout the day
• Losing weight if your child is obese
• Keeping the head in a higher position or elevated state while lying down and sleeping
• Avoiding tight and uncomfortable clothes

Natural Remedies for Acid Reflux in Children

Apart from the above-mentioned treatment options, there are many effective natural home remedial measures that may control the symptoms of acid reflux in children. Here are some effective natural remedies:

1. Yoghurt

You can give yoghurt to cure acid reflux in your child. Yoghurt has alkaline properties, which are very effective in soothing the oesophagus and maintaining the pH balance of the body. Yoghurt is also very safe, and unlike most antacids, it does not hamper protein absorption by the body.

2. Fennel Seeds

The presence of an enzyme called anethole in fennel seeds is very beneficial in controlling gastrointestinal spasms, and thus very good in treating GERD in children.

3. Coconut Oil

Having coconut oil on a daily basis reduces the symptoms of GERD to a great extent. This is because coconut oil has anti-inflammatory properties that soothe the stomach and reduce acid reflux.

4. Apple Cider Vinegar

Apple cider vinegar is very beneficial in keeping the pH balance of the body. You can give one tablespoon of ACV mixed in half a glass of water on a daily basis to your kid to keep GERD at bay.

5. Basil Leaves

Basil leaves are also effective in treating the symptoms of GERD in kids. Take a glass of water and add a few basil leaves to it. Boil till it reduces to one-third the amount, cool it, and then give it to your child to drink in the morning.

6. Aloe Vera

Aloe vera is very beneficial in controlling acid reflux in children. You can take a fresh aloe vera leaf and scrape out the gel, and boil this gel with some water. Give this concoction to your kid before every meal to avoid acid reflux.

7. Ginger

Ginger juice mixed in some warm water works wonders to prevent acid reflux in children. You should give this concoction on an empty stomach.

8. Baking Soda

The alkaline property of baking soda is very effective in maintaining the pH balance of the body. You can take a teaspoon of baking soda and mix it in a glass of water. Give this mixture to your kid to alleviate the symptoms of acid reflux.

9. Aniseed

Aniseed is a great treatment option for an upset and troubled stomach. Give a spoonful of aniseed to your kid to chew after every meal. Alternatively, you may soak it in water for three to four hours and give it to your kid after straining. You may add some sugar to the water for some taste.

10. Chewing Gum

Chewing gum is also one of the many effective home remedial measures to treat severe acid reflux in the child. Chewing helps in stimulating saliva, which helps in neutralizing the acids in the stomach.

11. Banana

Bananas are a gentle and natural remedy for acid reflux. They are low in acid and can help coat the esophagus to provide relief from the discomfort associated with acid reflux. They also contain natural antacids that can help buffer stomach acid.

Foods to Prevent Gastroesophageal Reflux Disease in Your Child

There are many triggers of an acid reflux, and knowing about them will help you keep your kid’s problem at bay. Here are some food items that you should not let your child have to prevent gastroesophageal reflux:

• Oily, spicy and fatty food items
• Chocolates and sugary foods
• Mint or peppermint
• Any citrus fruits such as organs, lemons, sweet limes, etc
• Tomatoes, and any dish prepared with tomatoes
• Caffeinated beverages
• Onions and garlic

When to Consult a Doctor?

Though with proper care and medical help you can easily control GERD in your child, sometimes certain complications may arise that may require immediate medical intervention. Following are some of the complications that you should immediately report to your child’s doctor:

• If your kid looks dehydrated
• If he is losing weight
• If he is vomiting a lot
• If the colour of his vomit is green or yellow or has blood stains in it
• If he experiences trouble breathing after vomiting

If you notice any of these symptoms, or other alarming symptoms, it is advised that you call your doctor for assistance. Timely treatment can ward off any major complication.

FAQs

1. Are Foods Like Bananas or Milk Good for Acid Reflux in Children?

Bananas are generally considered good for acid reflux in children due to their low acidity and natural antacid properties. However, the effect can vary among individuals. Milk is also sometimes used to relieve symptoms, but it’s not recommended for everyone, as it can trigger reflux in some children. It’s best to consult a healthcare professional for personalized dietary recommendations.

2. Why Does GERD Get Worse at Night in Children?

GERD (Gastroesophageal Reflux Disease) can worsen at night in children for several reasons. When a child lies down, gravity is no longer helping to keep stomach acid down, and acid can more easily flow into the esophagus. Additionally, nighttime GERD symptoms may be related to delayed stomach emptying and altered sleep patterns. Elevating the head of the child’s bed and avoiding large meals before bedtime can help mitigate nighttime GERD symptoms.

Make sure you serve light, home-cooked meals to your kid at regular intervals. As soon as you notice any GERD symptoms, start with the home remedial measures. However, it is best to consult your kid’s doctor before you give any home remedy to your kid.

References/Resources:

1. GERD Diet: Foods That Help with Acid Reflux (Heartburn); Johns Hopkins Medicine; https://www.hopkinsmedicine.org/health/wellness-and-prevention/gerd-diet-foods-that-help-with-acid-reflux-heartburn

2. Why Does Your Heartburn Always Seem Worse at Night?; Cleveland Clinic; https://health.clevelandclinic.org/why-does-your-heartburn-always-seem-worse-at-night/

3. Symptoms & Causes of GER & GERD in Children; National Institute of Diabetes and Digestive and Kidney Diseases; https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-children/symptoms-causes

4. GERD and Sleep; Sleep Foundation; https://www.sleepfoundation.org/physical-health/gerd-and-sleep#

5. Yeh. A, Golianu. B; Integrative Treatment of Reflux and Functional Dyspepsia in Children; National Library of Medicine; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4928719/; August 2014

6. Badgujar. S, Patel. V, Bandivdekar. A; Foeniculum vulgare Mill: A Review of Its Botany, Phytochemistry, Pharmacology, Contemporary Application, and Toxicology (BioMed Research International); National Library of Medicine; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4137549/; August 2014

7. Gastroesophageal Reflux Disease (GERD)/Heartburn; Cedars Sinai; https://www.cedars-sinai.org/health-library/diseases-and-conditions/g/gastroesophageal-reflux-disease-gerdheartburn.html

8. Poddar. U; Diagnosis and Management of Gastroesophageal Reflux Disease (GERD): An Indian Perspective; Indian Pediatrics; https://www.indianpediatrics.net/jan2013/jan-119-126.htm

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Indigestion in Kids
Gastritis in Children
Irritable Bowel Syndrome (IBS) in Kids