10/1/2018 Patient education: Acid reflux (gastroesophageal reflux disease) in children and adolescents (The Basics) - UpToDate

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Patient education: Acid reflux (gastroesophageal reflux disease) in children and adolescents (The
Basics)
Written by the doctors and editors at UpToDate

What is acid reflux? — Acid reflux (also called "gastroesophageal reflux" or just "reflux") is when the acid that is
normally in the stomach backs up into the esophagus (figure 1). The esophagus is the tube that carries food from
the mouth to the stomach.

A small amount of acid reflux is normal. But if the reflux happens frequently, it can cause problems with the
esophagus or lung infections (pneumonia). Reflux that has become more serious is called "gastroesophageal
reflux disease," or GERD.

Children with certain health issues have a higher risk of getting reflux. These include children with Down
syndrome, cerebral palsy, or other problems with the brain or spinal cord. Children who are overweight also are
more likely to have reflux.

What are the symptoms of acid reflux? — The symptoms depend on the child’s age.

Preschool children with acid reflux might:

● Vomit

● Taste stomach acid in the mouth, or feel it in the throat

● Not want to eat

● Lose weight

Older children or adolescents with acid reflux might:

● Taste stomach acid in the mouth, or feel it in the throat

● Have an upset stomach

● Feel burning in the chest (known as "heartburn")

● Have trouble swallowing

Having symptoms like these once in a while is normal. If any of these symptoms happen more than once a week,
this might be a sign of GERD.

Should my child see a doctor or nurse? — Yes. If you think your child might have acid reflux, talk to his or her
doctor or nurse before you try any treatments. He or she can suggest ways to help relieve symptoms. He or she
might also do tests to figure out if your child's symptoms are caused by reflux or something else.

Take your child to see a doctor or nurse right away if he or she:

● Has trouble swallowing, or feels as though food gets "stuck" on the way down
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● Loses weight

● Has chest pain

● Chokes when he or she eats

● Vomits blood

Is there anything I can do to help my child feel better? — Yes. There are some things that might help with
acid reflux, depending on your child's age and symptoms. Your child's doctor or nurse might suggest that you:

● Avoid giving your child foods that make symptoms worse (examples include chocolate, peppermint, and fatty
foods)

● Raise the head of your child's bed by 6 to 8 inches (for example, by putting blocks of wood or rubber under 2
legs of the bed or a Styrofoam wedge under the mattress). Do not raise the head of an infant's crib or bed.

● Help your child to lose weight, if he or she is overweight (ask your child's doctor or nurse for advice on how
to do this)

● Keep your child away from cigarette smoke

● Have your child avoid lying down for a few hours after a meal

How is acid reflux treated? — Most times, acid reflux symptoms can be treated with medicines. There are 3
main types of medicines that can help: antacids, histamine blockers, and proton pump inhibitors (table 1). All of
these medicines work by reducing or blocking stomach acid. But they each do that in a different way:

● Antacids can relieve mild symptoms, but they work only for a short time. You can buy them without a
prescription. Children younger than school age should not take antacids.

● Histamine blockers are stronger and last longer than antacids. You can also buy most histamine blockers
without a prescription.

● Proton pump inhibitors are the most effective medicines in treating GERD. You can buy some of these
medicines without a prescription. But there are other versions that your child's doctor or nurse can prescribe.

If you child's doctor or nurse recommends a medicine, he or she will usually suggest that your child try the
medicine for a few weeks first. Then if symptoms do not get better, the doctor or nurse might suggest a different
medicine, or decide to do tests.

Sometimes acid reflux medicines are less expensive if you get them with a prescription. Other times
nonprescription medicines are less expensive. If cost is a concern for you, ask your pharmacist how you might
reduce the cost of your child's medicines.

Talk to your child's doctor or nurse before you give your child any medicines for reflux.

A few children need surgery to treat their GERD. This is more likely in children who have a problem with the
brain or spinal cord (such as cerebral palsy), and if the GERD is causing problems like pneumonia.

More on this topic

Patient education: Acid reflux (gastroesophageal reflux) in babies (The Basics)

Patient education: Acid reflux (gastroesophageal reflux disease) in adults (The Basics)
Patient education: Reducing the costs of medicines (The Basics)

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Patient education: Acid reflux (gastroesophageal reflux disease) in children and adolescents (Beyond the Basics)
Patient education: Acid reflux (gastroesophageal reflux disease) in adults (Beyond the Basics)
Patient education: Acid reflux (gastroesophageal reflux) in infants (Beyond the Basics)
Patient education: Reducing the costs of medicines (Beyond the Basics)

All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Jan 10, 2018.

The content on the UpToDate website is not intended nor recommended as a substitute for medical advice,
diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care
professional regarding any medical questions or conditions. The use of UpToDate content is governed by the
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GRAPHICS

Upper digestive system in a child

This drawing shows where the esophagus, stomach, and small intestine are
located in a child.

Graphic 52952 Version 3.0

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Medicines used to reduce stomach acid

Medicine type Medicine name examples

Antacids* Calcium carbonate (sample brand name: Tums)

Aluminum hydroxide, magnesium hydroxide, and simethicone (sample brand name: Maalox)

Surface agents Sucralfate (brand name: Carafate)

Histamine blockers Ranitidine (brand name: Zantac)

Famotidine (brand name: Pepcid)

Cimetidine (brand name: Tagamet)

Proton pump inhibitors Omeprazole (brand name: Prilosec)

Esomeprazole (brand name: Nexium)

Pantoprazole (brand name: Protonix)

Lansoprazole (brand name: Prevacid)

Dexlansoprazole (brand name: Dexilant)

Rabeprazole (brand name: AcipHex)

* Some antacids contain aspirin, which can increase the risk of internal bleeding. Examples of antacids with aspirin include
Alka-Seltzer, Medi-Seltzer, and Neutralin. But there are others, too, so it's important to check labels. Talk to your doctor or
nurse before taking any medicines that contain aspirin.

Graphic 78918 Version 10.0

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