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Gastroesophageal Reflux Disease—Adolescent

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

See also:

Definition

Gastroesophageal reflux disease (GERD) is a disorder that results in food and stomach acid backing up into the esophagus from the stomach. GERD requires treatment to avoid complications, such as esophageal damage.
Gastroesophageal Reflux Disease
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Causes

The lower esophageal sphincter (LES) is a muscular ring between the esophagus and the stomach. It relaxes to let food pass into the stomach, then closes shut to prevent it from backing up. With GERD, the ring doesn't close as tightly as it normally should. This causes acid reflux, a burning sensation that can be felt below the breastbone.
The following factors contribute to GERD:

Risk Factors

Factors that may increase your teen's chance of GERD include:

Symptoms

GERD may cause:

Diagnosis

Your doctor will ask about your teen’s symptoms and medical history. A physical exam will be done.
Tests may include:
Imaging tests can assess LES function and surrounding structures. These may include:

Treatment

Treatment options vary based on the severity of the GERD. Options may include one or more of the following:

Lifestyle Changes

This may be all that is needed to relieve GERD symptoms. In some cases, these may be recommended before medication is prescribed. These changes can be tailored to an individual person based on their habits. Lifestyle changes include:
  • Eating smaller, more frequent meals.
  • Avoiding overeating.
  • Avoiding late night meals.
  • Sleeping with the head of the bed elevated.
  • Avoiding lying down within 2-3 hours after eating.
  • Wearing looser clothing that doesn't bind the stomach area.
  • Losing weight if needed.
  • Quitting smoking.
Foods and drinks to avoid may include:
  • Chocolate
  • Fried foods
  • Peppermint
  • Spicy foods
  • Caffeine products
  • Carbonated drinks
  • Foods high in fat and acid
  • Alcohol

Medications

Medication may be needed to 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 LES. This makes the LES stronger and prevents stomach acid from backing up into the esophagus.

Prevention

There are no current 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—The Hospital for Sick Children 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. Updated April 29, 2013. Accessed April 30, 2013.

Gastroesophageal reflux disease (GERD). Nemours Kids Health website. Available at: http://kidshealth.org/teen/diseases%5Fconditions/digestive/gerd.html. Updated June 2011. Accessed April 30, 2013.

Gastroesophageal reflux in children and adolescents. National Digestive Diseases Information Clearinghouse website. Available at: http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/ger-and-gerd-in-children-and-adolescents/Pages/facts.aspx. 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 GE reflux clinical practice guidelines. J Pediatr Gastroenterol Nutr. 2001;32:S1-S31.

3/1/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Maalox Total Relief and Maalox liquid products: medication use errors. US Food and Drug Administration website. Available at: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm200672.htm. Published February 17, 2010. Accessed April 30, 2013.

1/20/2015 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: National Institute for Health and Care Excellence. Gastro-oesophageal reflux disease: recognition, diagnosis and management in children and young people. January 2015. Available at: https://www.nice.org.uk/guidance/ng1. Accessed January 20, 2015.

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