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Gastroesophageal Reflux Disease—Adolescent

(GERD—Adolescent; Chronic Heartburn—Adolescent; Reflux Esophagitis—Adolescent; Gastro-oesophageal Reflux Disease—Adolescent; GORD—Adolescent; Heartburn—Adolescent; Reflux—Adolescent)

Pronounced: Gas-tro-ee-sof-a-geal re-flux

by Patricia Kellicker, BSN

En Español (Spanish Version)
 

Definition

Gastroesophageal reflux disease (GERD) is a disorder that results from food and stomach acid backing up into the esophagus from the stomach. GERD is different from gastroesophageal reflux (GER). GER is a common disorder seen in infants, which causes them to spit up. Most infants outgrow GER within 12 months.

This condition can cause serious health issues. Treatment for GERD includes lifestyle changes, medications, and sometimes surgery.

Gastroesophageal Reflux Disease

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Copyright © Nucleus Medical Media, Inc.

 

Causes

Food travels down the esophagus to the stomach. The opening between the esophagus and stomach opens to let food enter the stomach. Normally, it closes as soon as the food enters the stomach. With GERD, the opening does not close tightly. Stomach acid flows into the esophagus, called acid reflux, causing a burning sensation.

The following factors contribute to GERD:

  • Abnormal pressure to the lower esophageal sphincter (LES), a valve that keeps food in the stomach
  • Increased relaxation of LES
  • Increased pressure within the abdomen
 

Risk Factors

The following may increase the risk of GERD in adolescents:

 

Symptoms

If your teen has any of these symptoms, do not assume it is due to GERD. These symptoms may be caused by other conditions.

Symptoms may include:

  • Heartburn
  • Regurgitation
  • Abdominal or chest pain
  • Vomiting
  • Difficulty swallowing
  • Dry cough
  • Raspy voice
  • Sore throat
  • Recurrent pneumonia or worsening asthma
  • Weight loss, lack of appetite
 

Diagnosis

Your doctor will ask about your teen’s symptoms and medical history. A physical exam will be done.

Tests may include:

  • Upper GI series —a series of x-rays of the upper digestive system taken after drinking a barium solution
  • Upper endoscopy with biopsy—a tube is inserted into esophagus to look at the lining and a piece of tissue is taken for testing
  • 24-hour pH monitoring—a probe is placed in the esophagus to keep track of the level of acidity in the lower esophagus
  • Short trial of medication
 

Treatment

Talk with your teen's doctor about the best treatment plan. Treatment options include the following:

Lifestyle Changes

Before recommending medication, your teen's doctor may suggest lifestyle changes. These may include:

  • Eating smaller, more frequent meals
  • Avoiding late night snacks
  • Sleeping with the head of the bed elevated
  • Lose weight
  • Quit smoking
  • Avoid alcohol

Foods to avoid may include:

  • Chocolate
  • Fried foods
  • Peppermint
  • Spicy foods
  • Caffeine products
  • Carbonated beverages
  • Foods high in fat and acid

Medications

Medication will help relieve symptoms and heal any damage to the esophagus. Many medications for GERD are available over-the-counter and by prescription. Your teen's doctor may recommend the following:

  • Antacids
  • H-2 blockers
  • Proton pump inhibitors

Procedures

In more severe cases, the doctor may recommend surgery or endoscopy. The most common surgery is called fundoplication. During this procedure, the surgeon wraps part of the stomach around the lower esophageal sphincter. This makes the sphincter stronger and prevents stomach acid from backing up into the esophagus. In many cases, this procedure can be done through small incisions in the skin, called laparoscopy.

 

Prevention

There are no guidelines to prevent GERD.

RESOURCES::

Children’s Digestive Health and Nutrition Foundation
http://cdhnf.org

National Digestive Diseases Information Clearinghouse
http://digestive.niddk.nih.gov

CANADIAN RESOURCES::

About Kids Health
http://www.aboutkidshealth.ca

Canadian Digestive Health Foundation
http://www.cdhf.ca

REFERENCES::

Gastroesophageal reflux disease (GERD). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what. Updated April 29, 2013. Accessed April 30, 2013.

Gastroesophageal reflux disease (GERD). Nemours Teen's Health website. Available at: http://kidshealth..... Updated June 2011. Accessed April 30, 2013.

Gastroesophageal reflux in children and adolescents. National Digestive Diseases Information Clearinghouse website. Available at: http://digestive.n.... Updated February 21, 2012. Accessed April 30, 2013.

GERD in children and adolescents. Children’s Digestive Health and Nutrition Foundation website. Available at: http://gerd.cdhnf.org/User/Docs/PDF/AdolesGERDFlier.pdf . Accessed May 19, 2008.

Pediatric gastroesophageal reflux, clinical practice guideline summary. Children’s Digestive Health and Nutrition Foundation website. Available at: http://gerd.cdhnf.... . Accessed May 19, 2008.

Pediatric GE reflux clinical practice guidelines. J Pediatr Gastroenterol Nutr. 2001;32:S1-S31.

Transoral incisionless fundoplication with EsophyX. Endogastric Solutions website. Available at: http://www.endogastricsolutions.com/esophyx_for-pt.htm . Accessed August 19, 2009.

3/1/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Maalox Total Relief and Maalox liquid products: medication use errors. US Food and Drug Administration website. Available at: http://www.fda.gov.... Published February 17, 2010. Accessed April 30, 2013.


Last reviewed April 2013 by Daus Mahnke, MD; Brian Randall, MD
Last Updated: 4/30/2013

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