Acid Reflux in Children and Adolescents

Are you concerned that your child has acid reflux? 

Well, look no further. This article is here to help! 

How do I know if my child has reflux? 

First, always talk to your pediatrician with any concerns related to your child. 

Second, here are some common symptoms of acid reflux in children aged over the age of one: regurgitation, recurrent vomiting, abdominal pain, cough, asthma, hoarse voice, and tooth erosions. 

One study showed that the biggest complaint in children with acid reflux was stomach pain. Some other thoughts about the associations of reflux include pharyngitis (sore throat), sinusitis (inflammation of the nasal sinus), and recurrent ear infections. 

Generally speaking, acid reflux in children is not commonly associated with poor growth. 

Is it common that my child has acid reflux? 

Some research proposes that around 10% of children, maybe even more, have GERD symptoms at least one time per week. 

So, what can we do to help our children with reflux? 

Weight management:

If your child is overweight, a healthier lifestyle should be incorporated in hopes for weight loss – more fruits and vegetables, more fiber and lean proteins, less sugar-sweetened beverages and more physical activity. 

Potential food triggers:

Avoid things that may increase reflux symptoms. Some possible things to avoid are caffeine, chocolate, spearmint, and spicy foods.

After meals:

Try sugar-free gum (if age appropriate) and walking after eating. 

Medications:

The two major classes of medications used for reflux in children are acid suppressants and prokinetic agents. Acid suppressants have been shown to be more effective than prokinetic agents. Also, newer studies have not shown enough evidence to support prokinetic agents for GERD treatment. 

There are three types of acid suppressants: antacids, histamine-2 receptor antagonists (H2RAs) and proton pump inhibitors (PPIs).

Long term use of antacid therapy is commonly not recommended in the pediatric population due to milk-alkali syndrome (increased calcium levels in the body and decreased kidney function). H2RAs are often not used long term due to rapid tachyphylaxis (the body stops responding to this particular medication over time and can happen within 6 months). 

If your child is prescribed a PPI, dosing is VERY important. It is recommended to give your child a PPI around 30 minutes prior to meals. Studies have shown PPI’s to be considered safe for long term use, even up to 11 years. Some common side effects known with PPIs are headaches, diarrhea, constipation and nausea. 

Surgery:

This should really be a last case scenario. If lifestyle modifications and medication do not work to treat your child’s reflux, push your child’s pediatrician to look for other answers or a different diagnosis. 

As always, please talk to your child’s pediatrician to help. 

Is your child less than 1 years old?
Check out this article on acid reflux in infants

Lightdale, J. R., Gremse, D. A., Heitlinger, L. A., Cabana, M., Gilger, M. A., Gugig, R., & Hill, I. D. (2013, May 1). Gastroesophageal reflux: Management guidance for the pediatrician. American Academy of Pediatrics. Retrieved April 19, 2022, from https://publications.aap.org/pediatrics/article/131/5/e1684/31266/Gastroesophageal-Reflux-Management-Guidance-for 

U.S. Department of Health and Human Services. (n.d.). Acid reflux (ger & gerd) in children. National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved April 16, 2022, from https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-children

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