Gastroesophageal Reflux Disease (GERD)

Many adults, at one time or another, have experienced heartburn and an uncomfortable feeling in the chest after a big meal, or after eating spicy foods.

When these symptoms are frequent or can't be attributed to certain ingredients, they may be due to gastroesophageal reflux disease (GERD). And the condition isn't just a problem for adults, it affects kids too. In infants, GERD can cause vomiting and fussiness after feeding. And in older kids and teens, GERD can lead to heartburn, stomach, and chest discomfort.

Most kids outgrow GERD on their own, but some cases require treatment.

About GERD

The burping, heartburn, and spitting up associated with GERD are the result of acidic stomach contents moving backward into the esophagus (called reflux). This can happen because the muscle that connects the esophagus with the stomach (the esophageal sphincter) relaxes at the wrong time or doesn't properly close.

Many people have reflux regularly and it's not usually a cause for concern. But with GERD, reflux occurs more often and causes noticeable discomfort. After nearly all meals, GERD causes heartburn, also known as acid indigestion, which feels like a burning sensation in the chest, neck, and throat.

In babies with GERD, breast milk or formula regularly refluxes into the esophagus, and sometimes out of the mouth. Sometimes babies regurgitate forcefully or have "wet burps."

Most babies outgrow GERD between the time they are 1 and 2 years old. But in some cases, GERD symptoms persist. Kids with developmental or neurological conditions, such as cerebral palsy, are more at risk for GERD and can have more severe, lasting symptoms.

Symptoms of GERD

Heartburn is the most common symptom of GERD in kids and teens. It can last up to 2 hours and tends to be worse after meals. In infants and young children, GERD can lead to problems during and after feeding, including:

• frequent regurgitation or vomiting, especially after meals
• choking or wheezing, if the contents of the reflux get into the windpipe and lungs
• wet burps or wet hiccups
• spitting up that continues beyond the first year of life (when it typically stops for most babies)
• irritability or inconsolable crying after eating
• refusal to eat, at all or in limited amounts
• failure to gain weight

These symptoms may be worse if a baby lies down or is placed on in a car seat after a meal.

Complications of GERD

Some children develop complications from GERD. The constant reflux of stomach acid can lead to: 

• breathing problems (if the stomach contents enter the trachea, lungs, or nose)
• redness and irritation in the esophagus, a condition called esophagitis
• bleeding in the esophagus
• scar tissue in the esophagus, which can make it difficult to swallow

Because these complications can make eating painful, GERD can interfere with proper nutrition. So if your child isn't gaining weight as expected or is losing weight, it's important to talk with your doctor.

Diagnosing GERD

In older kids, doctors usually can diagnose GERD by doing a physical exam and hearing about the symptoms. Try to keep track of the foods that seem to bring on symptoms in your child — this information can help the doctor determine what's causing the problem.