GASTROESOPHAGEAL REFLUX (GER)

Gastroesophageal reflux, or GER, is generally a self-limited condition that gets better with time. The symptoms of GER tend to peak between four and six months of age.

The symptoms of gastroesophageal reflux in infants include the following:
Feeding refusal
Recurrent vomiting
Arching of the back
Poor weight gain
Irritability
Excessive crying
Sleep disturbance

The symptoms of gastroesophageal reflux in older children/adolescents include the following:
Recurrent vomiting
Heartburn
Difficulty swallowing
Asthma
Recurrent pneumonia
Upper airway symptoms (chronic cough/hoarse voice)

Treatment

Gastroesophageal reflux in infants can be managed by the following these guidelines:

• Try to feed your baby more often, but decrease the amount of each feeding.
• Consider thickening bottle feeds (breast milk or formula) with cereal.
• Position your baby upright for 20-30 minutes after every feeding.
• Consider trying a hypoallergenic formula.
• Consider medication, if conservative measures have not been working.

Gastroesophageal reflux in older children can be managed by the following these guidelines:

• Avoid large meals.
• Avoid lying down immediately after eating.
• If your child is overweight, encourage him or her to lose weight.
• Avoid caffeine, chocolate, and spicy foods, all of which can make symptoms worse.
• Eliminate exposure to tobacco smoke.
• Consider medication, if conservative measures have not been working.

Call the office IF your child exhibits:

• Forceful vomiting
• Onset of persistent vomiting in a child 6 months or older
• Bloody stools
• Abdominal tenderness or distention
• Fever, lethargy, or enlarged liver
• Unusual head size
• Seizures

References:

Diagnosing and Treating Pediatric Acid Related Disorders. CME Program. Jointly sponsored by The Dannemiller Memorial Education Foundation and The Customer Link, Inc.

Conquering the Treatment Challenges of Pediatric Reflux Disease. CME Teleconference. Jointly sponsored by The Dannemiller Memorial Education Foundation and The Customer Link, Inc.

Barron SA et al. Pediatrics in Review. Volume 22 (8):274-275.