Gastroesophageal reflux disease, also known as GERD, is often regarded as an ailment that affects only adults; but in fact, many children and infants suffer from it too. Findings of the medical community show that, in addition to the familiar digestive complications associated with GERD, breathing problems and airway obstruction are a risk in young patients.GERD is characterized by the regurgitation of the stomach’s contents into the back of the throat. In children, it can be caused by normal stomach movement and is associated with a number of congenital problems and childhood illnesses involving breathing and the digestive tract.
Occasional indigestion in children is not uncommon, and many babies regurgitate food or “spit up” at times. For this reason GERD may be relatively difficult to detect in younger patients. Symptoms can be hard to identify as signs of GERD, but may include coughing, choking, noisy or labored breathing, weight loss, and irritability. Children old enough to talk about their symptoms may also complain of upset stomach or a burning feeling in their throat.
Because the esophagus leads directly to the upper throat, which is in turn connected to the breathing passages, any fluid or stomach contents present may obstruct breathing or be pulled down into the lungs, causing coughing and breathing difficulty. Stomach fluid contains strong acid, so any aspirated materials resulting from reflux can irritate the throat or lungs, and lead to infection, especially in fragile lung tissue.
There is also a connection between asthma and GERD. The two conditions occur together frequently, and doctors cite airway irritation due to stomach acid and abnormal movements of the upper throat (such as coughing, wheezing, and choking associated with an asthma attach) as two reasons why the conditions seem to work in concert.
In infants, GERD can cause or exacerbate apnea (stopped breathing) and lead to bradycardia (abnormally slow heart rate), especially during sleep. The instance of reflux and its dangerous nighttime side effects can be reduced, however, by taking several precautions: by angling infants’ mattresses so that their heads are elevated and stomach contents are kept in place by gravity, avoiding feedings right before bed, and reducing the amount of fatty or acidic foods responsible for provoking volatile acid production. These measures may also help older children, reducing the chance of both dangerous aspiration and discomfort.
Parents who suspect their children may have GERD or notice digestive or breathing problems in their children should talk to their pediatrician or health care specialist about the appropriate course of action. GERD can be diagnosed with the aid of several tests. One method, an upper GI x-ray, uses a special solution containing barium to make the esophagus visible, and can show abnormal activity or damage in the upper digestive tract. Endoscopy is another test that may be helpful, and involves the use of a tiny tube with a camera to explore the throat, esophagus, and stomach. An esophageal pH probe is a third method, and uses a probe inserted through the nose and down into the esophagus to monitor acid in the area.
Once GERD has been diagnosed, there are several methods of treatment available. The treatment used will depend on both the child’s age and responsiveness to the remedy, as well as the underlying cause of GERD, if any. For severe cases, surgery may be the best option for treatment.
