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GERD in Adults and Children
In adults, gastrointestinal reflux disorder, or GERD, causes two or more episodes a week of symptoms such as acid reflux, and pain and a burning sensation in the chest and throat. These episodes are generally triggered by spicy foods, fatty foods, caffeine, or alcohol.
The underlying cause of GERD is a weakness in a ring of muscle called the lower esophageal sphincter, or LES. This ring of muscle acts as a valve that holds the stomach closed to prevent regurgitation of stomach contents into the esophagus. In people with GERD, the LES does not close properly, allowing stomach acid to rise into the esophagus. Food triggers can prevent the LES staying closed, and factors such as smoking and being overweight can make the problem worse.
In infants and children the disease is somewhat different, as infant GERD symptoms are extremely common, to the point where they are considered normal in children up to eighteen months old. Treatment for simple acid reflux is generally not needed, but in some cases there might be a deeper cause of the condition that might require closer examination.
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Infant GERD Symptoms
For parents, it’s important to understand infant GERD symptoms, simply because an infant cannot tell her parents where she is feeling pain or discomfort. Parents can only see the signs of GERD, so knowing what these are is crucial.
An infant with GERD might have some or all of the following signs and symptoms:
- Feeding refusal: Sometimes, GERD can make the stomach feel full even when it contains little food. In addition, GERD can cause pain when swallowing if repeated episodes cause throat inflammation. Many infants will therefore only take a little food at each feeding, or might refuse food altogether.
- Food regurgitation or vomiting: Failure of the LES to close means that infants with GERD can regurgitate food during or shortly after feeding, or vomit between feedings.
- Frequent hiccups or burping: These symptoms appear because GERD can interfere with digestion, and increase the amount of gas in the stomach. Hiccups and burps are often “wet”, meaning a small amount of fluid is regurgitated.
- Lack of weight gain, failure to thrive: Infant GERD can prevent normal weight gain because the infant isn’t getting the nutrients he or she needs.
- Blood in vomit or stool: In severe cases GERD can cause stomach bleeding, leading to the presence of blood in stool and/or vomit.
- Respiratory symptoms: Coughing, wheezing, asthma-like symptoms, or even bronchitis or pneumonia, can result if refluxed stomach contents are aspirated into the bronchioles or lungs.
- Crying and irritability: In addition, infants with GERD are likely to cry more than usual, and might be irritable between meals. Often, this is due to pain as a result of esophageal inflammation.
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What to do about Infant GERD Symptoms
It's always a good idea to mention any unsual infant symptoms to a doctor or other healthcare professional, even if they seem unimportant. Acid reflux might be common in infants, but due to risks of GERD complications, all symptoms should be reported. An infant with severe GERD symptoms might be referred to a specialist who can help determine if there is a particular reason for the severity of symptoms.
At home, parents can try strategies such as feeding smaller meals, thickening formula slightly with rice cereal, and holding the infant upright during and after feedings. These measures can sometimes reduce frequency of GERD episodes, and help alleviate pain.
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National Institute of Diabetes and Digestive and Kidney Diseases at the National Digestive Diseases Information Clearing House: Heartburn, Gastroesophageal Reflux (GER), and Gastroesophageal Reflux Disease (GERD)
Samuel Nurko, MD, MPH. Treating Acid Reflux in Infants.
The Mayo Clinic: Infant Acid Reflux