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Gastroesophageal Reflux Disease in Children With Disabilities

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by Kellicker PG

(GERD—Child With Disabilities; Chronic Heartburn—Child With Disabilities; Reflux Esophagitis—Child With Disabilities; Gastro-oesophageal Reflux Disease—Child With Disabilities; GORD—Child With Disabilities; Heartburn—Child With Disabilities; Reflux—Child With Disabilities)

 

Symptoms

Symptoms of GERD include:
  • Difficulty swallowing or choking with feedings
  • Apnea or blue skin, which occurs when not enough oxygen gets to the airways
  • Refusal to eat
  • Increased mouth secretions
  • Regurgitation or vomiting
  • Bloody vomit
  • Weight loss or poor weight gain
  • Pain in the abdomen or chest
  • Frequent pneumonia or respiratory problems
  • Coughing or wheezing
  • Hoarseness
  • Arching back while feeding
  • Irritability or restlessness while feeding
 

Treatment

There are three goals for treatment. The first is to prevent injury to the esophagus. The second is to make sure the child is eating enough. The third goal is to keep the backed up food and acid from getting into the lungs. This will require a team approach. Your child may work with the pediatrician, specialized doctors, and a variety of therapists.
Talk with your doctor about the best treatment plan for your child. Treatment options include:

Feeding Management

It is important that your child is able to get the food needed for good health. GERD can make it difficult for your child to eat. Your doctor may recommend a feeding tube . This is a tube that is inserted through your child's nose to your child’s stomach. It will deliver the nutrients your child needs. The feeding tube will also decrease the risk of choking and ease the stress of feeding.

Medications

Most GERD in children can be relieved with lifestyle changes. Medication may be given if your child's GERD doesn't improve. The medication can help to decrease acid in the stomach and help the esophagus heal. Medication options may include:
  • Histamine-2 receptor drugs—to decrease acid production and promote healing
  • Proton pump inhibitors—also decreases acid production and promote healing
Many of these are over-the-counter medications that are available in liquid or powder form.

Procedures

Surgery or endoscopy may be recommended with more severe cases.
The most common surgery is called fundoplication . During this procedure, a part of the stomach will be wrapped around the stomach valve. This makes the valve stronger. It should prevent stomach acid from backing up into the esophagus. This surgery is often done through small incisions in the skin.
 

RESOURCES

North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition
http://cdhnf.org

National Digestive Diseases Information Clearinghouse (NDDIC)
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/what.php . Updated May 9, 2013. Accessed May 10, 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 August 2006. Accessed May 10, 2013.


Gastroesophageal reflux disease in infants. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated June 22, 2012. Accessed May 10, 2013.


Pediatric GE reflux clinical practice guidelines. J Pediatr Gastroenterol Nutr. 2001;32:S1-S31.

 

Revision Information

  • Reviewer: Michael Woods
  • Review Date: 05/2013
  • Update Date: 03/18/2013