Gastroesophageal Reflux Disease—Adolescent

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

    Gastroesophageal reflux disease (GERD) is a disorder that results from food and stomach acid backing up into the esophagus from the stomach.
    This condition can cause serious health issues. Treatment for GERD includes lifestyle changes, medications, and sometimes surgery.
    Gastroesophageal Reflux Disease
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  • Causes

    The valve between the esophagus and stomach opens to let food enter the stomach. With GERD, the valve 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:
    • 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

    Adolescent GERD may cause:
    • 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:
    • 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—helps confirm diagnosis if GERD symptoms are relieved during the trial period
    Images of internal body structures may be taken with:
  • 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 patient based on their habits. Lifestyle changes include:
    • Eating smaller, more frequent meals
    • Avoid overeating
    • Avoid late night meals
    • Sleeping with the head of the bed elevated
    • Avoid lying down within 2-3 hours after eating
    • Consider looser clothing that doesn't bind the stomach area
    • Lose weight
    • Quit smoking
    Foods and beverages to avoid may include:
    • Chocolate
    • Fried foods
    • Peppermint
    • Spicy foods
    • Caffeine products
    • Carbonated beverages
    • 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 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 Teen's 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://digestive.niddk.nih.gov/ddiseases/pubs/gerinchildren/index.htm. 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.org/User/Docs/PDF/GERD%5F8%5Fpg%5Fbrochure%5F031604.pdf. 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%5Ffor-pt.htm. Accessed August 19, 2009.

    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.

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