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Acid Reflux (GERD) In Children: Causes, Symptoms, And Treatment

Acid Reflux In Children

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IN THIS ARTICLE

Acid reflux or gastroesophageal reflux (GER) is the involuntary passage of gastric contents into the esophagus. It is normal for a child to have occasional episodes of acid reflux as they usually stop with a few dietary changes. But if they occur along with other complications, then it is good to consult a doctor.

In this post, MomJunction tells you about the causes, symptoms, and a few natural remedies which might help in reducing acid reflux in children.

Acid Reflux Symptoms In Children

The classic symptoms of acid reflux in children include:

  • Nausea and frequent regurgitation and vomiting almost immediately after eating something
  • Regular heartburn, such as a burning and painful sensation in the chest, behind the breastbone, and a burning sensation in the middle of the stomach (in children 12 years and up)
  • Pain when you swallow, difficulty swallowing
  • Refusal to eat
  • Bad breath
  • A sour taste in the mouth, especially in the mornings
  • Choking and wheezing, when food enters the windpipe (1)

When Does Acid Reflux Become Gastroesophageal Reflux Disease (GERD)?

If your child is experiencing acid reflux for more than twice a week continuously for a few weeks, then it could be GERD (1). It is a more severe condition and migh require a doctor’s diagnosis.

When To Take Your Child To The Doctor?

According to the University of Rochester Medical Center, call the doctor immediately if your child:

  • Vomits a lot and/ or it contains blood
  • Has breathing trouble, wheezing and coughing
  • Shows signs of dehydration
  • Has lost weight (2)

Some of the primary symptoms of acid reflux may also indicate other minor ailments. So you may not rush your child to the doctor if he or she vomits a little, complains of a stomach ache or refuses to eat once in a while. But if these symptoms are consistent and frequent, it is a cause for concern and warrants a trip to the doctor.

[Read: Indigestion In Children]

Causes Of Acid Reflux In Children

Acid reflux in children might occur when the lower esophageal sphincter (LES) relaxes too often or takes too long to relax. It causes the stomach acid to flow back to the esophagus.

If your child has occasional acid reflux, then it might be due to some lifestyle issues such as:

  • Obesity
  • Overeating
  • Having more of citrus, chocolate, fatty and spicy foods
  • Consuming alcohol (in the case of teens)
  • Long-term usage of aspirin and a few over-the-counter nonsteroidal antinflammatory drugs such as ibuprofen and naproxen
  • Allergic condition of the esophagus (3)

Occasional acid reflux could stop with some lifestyle changes. However, if acid reflux is severe and occurs more frequently, then the cause could lie deeper.

Causes Of GERD In Children

A few causes for GERD might be (4):

  • Neurological impairment, such as cerebral palsy, which affects body movements and muscle coordination.
  • Neuromuscular disorders such as congenital myopathy, which is a birth defect that causes progressive muscle weakness.
  • Trachea-esophageal fistula surgery, which is corrective surgery for birth defects in the esophagus and trachea.
  • Genetic conditions such as Trisomy 21, which is a condition of having an additional chromosome. Another condition is having a strong family history of GERD.
  • Congenital diaphragmatic hernia, which is birth defects in the diaphragm muscles.
  • Lung diseases, such as asthma and bronchiectasis.
  • Significant prematurity, which happens when babies are born before 28 weeks of pregnancy.

Your doctor is the best person to assess and diagnose your child. In the next section, we tell you about some of the methods doctors might use to diagnose acid reflux or GERD.

[Read: Causes Of Vomiting In Kids]

Diagnosing Acid Reflux Or GERD In Children

The doctor would first check for the symptoms mentioned above. Medical history of the child and growth chart is often enough for the doctor to diagnose GERD in children. In some cases, further tests may be recommended. They include:

  • A pH probe, which is a complicated test that determines the acid levels in the esophagus
  • A Barium swallow or upper GI test, which is a special X-ray test highlighting the esophagus, stomach, and part of the small intestine
  • Gastric emptying study
  • Upper GI endoscopy, to look inside the stomach, esophagus and the small intestine (5)

Once the diagnosis is done, the doctor will recommend a course of treatment.

Treatment For Acid Reflux And GERD In Children

Starting from basic lifestyle and diet changes to medications, treatment for acid reflux and GERD depends on the severity of the symptoms. For younger children, doctors usually recommend changes in diet and lifestyle to prevent triggering the disorder. Here are some of them:

  • Eat more often, but eat smaller meals each time. Avoid eating at least three hours before bedtime.
  • Fatty foods, spicy foods, carbonated drinks, acidic fruits, and vegetables that can irritate the tummy are a no-no.
  • If the child is obese, weight loss is recommended to decrease any possible pressure on the abdomen.
  • Keep the head in an elevated position when sleeping, and preferring to sleep towards the left side.
  • Avoid wearing tight clothes.
  • Do not eat large or heavy meals before vigorous exercise, a game, or any other stressful event.

In addition to these tips, the doctor may also prescribe acid reflux medication such as:

  • Antacids
  • Proton pump inhibitors like Nexium, Prevacid
  • Histamine-2 blockers to help reduce the acid in the stomach

Surgical treatment might be recommended to children with chronic-relapsing GERD, and when all the alternative treatment options fail to give relief (5).

Remember that these medications should not be taken without the doctor’s advice. In most cases, a strict GERD diet and a healthy lifestyle can help in controlling the acid reflux symptoms in children. 

[Read: Home Remedies For Diarrhea In Kids]

Natural Remedies For Acid Reflux In Children

In addition to lifestyle changes and prescribed medicines, you could consider home remedies to reduce the symptoms of acid reflux and GERD in children. However, these may not cure reflux and cannot replace a doctor’s advice. Take your doctor’s advice before trying any of these remedies for your children.

1. Yogurt

Eating yogurt might help reflux. Studies have shown that the fermentation of milk generates bioactive peptides, which could help in protecting the gut wall (6).

How to: Give the child half a cup of plain fresh yogurt every day after a meal.

2. Sugarless gum

Chewing gum may help increase the swallowing frequency, thereby improving the clearance rate of esophagus (7).

How to: Giving your child sugarless chewing gum after a meal might help in reducing acid reflux.

3. Fennel seeds

Besides being an excellent digestive, fennel seeds might also help in reducing acidity. The seeds have an enzyme called anethole, which has antispasmodic properties that might help in reducing acid reflux (8).

How to: If your child is old enough to chew, then given them a spoonful of fennel seeds to chew after meals.

[Read: Causes Of Nausea In Children]

4. Aniseed and cumin seed

It is said that aniseed has a soothing effect on a troubled stomach, so might be helpful to reduce acid reflux.

How to:

  • Get the child to chew some aniseed after eating food.
  • Alternatively, soak the aniseed along with sugar candy in a cup of water for three to four hours. Strain the water and give it to the child to drink.
  • You can also consider using aniseed paste to egg and meat dishes to help digest it properly, and prevent any heartburn.

Likewise, cumin seeds can be used to treat acid reflux in children. Besides using them in your food (Indian dishes), you can also get the child to chew these seeds if he has a burning sensation in the stomach. Then drink a glass of water immediately for relief.

5. Ginger root

Ginger root could be used for reducing acid reflux. Studies found that ginger root improved gastric emptying and gastroduodenal mobility in fasting and fed state (9).

How to:

  • Clean a piece of ginger, peel and grate it. Extract the juice from it and mix it with a glass of warm water. Give it to the child to drink on an empty stomach.
  • You can also use ginger in food to prevent acid reflux symptoms.

6. Aloe vera

Studies found that aloe vera is a safe and effective treatment for reducing the symptoms of GERD (10).

How to:

  • Slit an aloe vera tube and take the gel out from it. Add that gel to water and boil it.
  • Let the concoction cool down and then refrigerate it.
  • Give it to the child before a meal to prevent acid reflux.

7. Basil leaves

Basil or Tulsi leaves are believed to be effective in treating the symptoms of acid reflux.

How to:

  • Take a few basil leaves and boil them in a bowl of water. Let it reduce to one-third its original quantity. Let it cool and drink it in the morning.
  • Alternatively, you can crush the basil leaves and extract the juice.

8. Apple cider vinegar

Although there is no scientific evidence to prove its effectiveness(11), anecdotal evidence suggests that it might work to reduce acid reflux.

How to: Combine one teaspoon of ACV with half a glass of water and give it to him in the morning. This will help restore the pH balance in the stomach.

9. Coconut oil

Coconut oil has anti-inflammatory properties (12) and might help reduce the inflammation caused due to acid reflux. However, research says that coconut oil should be consumed in.

How to: Give one teaspoon of coconut oil to the child once a day. You can add the oil to a warm drink or use in foods. However, make sure your child is not allergic and also consult with your doctor before administering coconut oil orally to your child.

These home remedies help in alleviating the symptoms of acid reflux, but not curing it entirely.

[Read: Symptoms Of Stomach Pain In Children]

Foods To Avoid To Prevent Acid Reflux

Is milk good for acid reflux? Can my children eat candy when they have acid reflux? What can they eat to prevent acid reflux?

If these are some of the questions you have, you should know about the foods that can trigger the symptoms of acid reflux.

  • Chocolate
  • Peppermint or mint
  • Spicy, oily or greasy foods – avoid all types of fast foods
  • Tomatoes or anything made from tomatoes
  • Citrus fruits such as oranges, lemon, etc. (13)

Try and give the child only homemade foods as far as possible. Control or limit the portions, as overeating can also trigger nausea and vomiting associated with acid reflux. If the doctor has prescribed any medications, check if it is okay to use these home remedies along with the medicines.

Have any tips that can help children with acid reflux? Share them with us here.

References

1. Reflux in children; Medline Plus; US National Library of Medicine
2. GERD (Gastroesophageal Reflux Disease) in Children; University of Rochester Medical Centre
3. Gastroesophageal Reflux Disease (GERD)/Heartburn; Cedars Sinai
4. Ujjal Poddar; Diagnosis and Management of Gastroesophageal Reflux Disease (GERD): An Indian Perspective; Indian Pediatrics
5. Yvan Vandenplas, et al.; Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN); Journal of Pediatric Gastroenterology and Nutrition
6. Bert J. M. van de Heijning, Amelie Berton, Hetty Bouritius, and Olivier Goulet; GI Symptoms in Infants Are a Potential Target for Fermented Infant Milk Formulae: A Review; NCBI(2014)
7. Moazzez R, Bartlett D, Anggiansah A; The effect of chewing sugar-free gum on gastro-esophageal reflux; NCBI(2005)
8. Shamkant B. Badgujar, Vainav V. Patel, and Atmaram H. Bandivdekar; Foeniculum vulgare Mill: A Review of Its Botany, Phytochemistry, Pharmacology, Contemporary Application, and Toxicology; NCBI(2014)
9. Ann Ming Yeh, and Brenda Golianu; Integrative Treatment of Reflux and Functional Dyspepsia in Children; NCBI(2014)
10. Panahi Y, Khedmat H, Valizadegan G, Mohtashami R, Sahebkar A; Efficacy and safety of Aloe vera syrup for the treatment of gastroesophageal reflux disease: a pilot randomized positive-controlled trial; NCBI(2015)
11. Is Apple Cider Vinegar Good for Acid Reflux?; Cleveland Clinic
12. Renan da Silva Lima, Jane Mara Block; Coconut oil: what do we really know about it so far?; Oxford Academic Food Quality and Safety
13. Jung Wan Choe, et al.; Foods Inducing Typical Gastroesophageal Reflux Disease Symptoms in Korea; NCBI(2017)
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