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Gastroesophageal Reflux Disease (GERD)

Gastroesophageal Reflux Disease (GERD) occurs when acid from the stomach and lower gastrointestinal tract refluxes up into the esophagus and potentially the upper airway structures, causing irritation and inflammation.

Some degree of reflux is a normal physiological occurrence. GERD refers to symptoms and complications that may develop secondary to persistent reflux that are troublesome or affect quality of life.

Diagnosis and Testing

When symptoms of heartburn, acid taste and discomfort are present, empiric acid suppression therapy is usually initiated and clinical improvement of symptoms may establish the diagnosis.

A common study used for evaluation of acid reflux is a 24-hour esophageal pH monitor. A small probe is passed through the nose into the esophagus. The tube has sensors at various levels that detect acid levels. The tube is attached to a monitor that is worn for 24 hours. It has buttons to record the child’s position and a log is kept recording the child’s activities at certain intervals.

Treatment

Proton pump inhibitors (PPI) such as Prilosec or Prevacid are the first line of treatment for GERD and are safe for very young children. The goal of these medications is to suppress the secretion of acid. Another medical treatment for GERD is the use of pro-motility agents such as Erythromycin to increase the movement substances through the gastrointestinal tract.

Lifestyle management such as dietary changes can sometimes improve symptoms.

If treatment with medication fails to alleviate symptoms, surgical intervention may be considered.

For more information about GERD, please speak with your child's physician.