Gastroesophageal reflux disease (GERD)
Gastroesophageal reflux disease (GERD) is a digestive disorder that is caused
by gastric acid flowing from the stomach into the esophagus. Gastroesophageal
refers to the stomach and esophagus, and reflux means to flow back or return.
Gastroesophageal reflux (GER) is the return of acidic stomach juices, or food
and fluids, back up into the esophagus. GER is very common in infants, though it
can occur at any age. It is the most common cause of vomiting during infancy.
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What causes GERD?
GERD is often the result of conditions that affect the lower esophageal
sphincter (LES). The LES, a muscle located at the bottom of the esophagus, opens
to let food in and closes to keep food in the stomach. When this muscle relaxes
too often or for too long, acid refluxes back into the esophagus, causing
vomiting or heartburn.
Everyone has gastroesophageal reflux from time to time. If you have ever
burped and had an acid taste in your mouth, you have had reflux. The lower
esophageal sphincter occasionally relaxes at inopportune times, and usually, all
your child will experience is a bad taste in the mouth, or a mild, momentary
feeling of heartburn.
Infants are more likely to have the lower esophageal sphincter (LES) relax
when it should remain shut. As food or milk is digesting, the LES opens and
allows the stomach contents to go back up the esophagus. Sometimes, the stomach
contents go all the way up the esophagus and the infant or child vomits. Other
times, the stomach contents only go part of the way up the esophagus, causing
heartburn, breathing problems, or, possibly, no problems at all.
Some foods seem to affect the muscle tone of the lower esophageal sphincter,
allowing it to stay open longer than normal. These include, but are not limited
to, the following:
- Chocolate
- Peppermint
- High-fat foods
Other foods increase acid production in the stomach, including:
- Citrus foods
- Tomatoes and tomato sauces
Why is gastroesophageal reflux disease (GERD) a concern?
Some infants and children who have gastroesophageal reflux may not vomit, but
may still have stomach contents move up the esophagus and spill over into the
windpipe. This can cause asthma, pneumonia, and possibly even SIDS (sudden
infant death syndrome).
Infants and children with GERD who vomit frequently may not gain weight and
grow normally. Inflammation (esophagitis) or ulcers (sores) can form in the
esophagus due to contact with stomach acid. These can be painful and also may
bleed, leading to anemia (too few red blood cells in the bloodstream).
Esophageal narrowing (stricture) and Barrett's esophagus (abnormal cells in the
esophageal lining) are long-term complications from inflammation.