Gastroesophageal reflux disease in children

Between the stomach and the esophagus is the upper stomach. If it does not hold tightly, the contents of the stomach can be pushed up into the esophagus. It is called gastroesophageal reflux. If the stomach contents that are upset affect the child negatively, it is called gastroesophageal reflux disease.

Symptoms of gastroesophageal reflux disease

A child up to the age of one who has gastroesophageal reflux disease is vomited after eating, but may also refuse to eat and hurt when eating. In severe and prolonged reflux, the mucous membrane of the esophagus can be irritated, which hurts. The child can then become fussy and whiny, and even sleep worse. Weight gain stops and some children may even lose weight.

Occasionally, stomach contents may drain into the airways. It can lead to trachea and coughing, especially during the night, or pneumonia .

Children who are about four years of age or older can complain that they have an upset stomach and say that it is burning behind the sternum. Often, the trouble becomes worse when the child is lying down. They also often get acid reflux, but even children who do not have reflux can get acid reflux.

Seek care

Contact a child care center or child care center about the child

  • is often vomited and much
  • does not gain weight properly
  • do not want to eat
  • seems to hurt when they eat
  • sleeping anxiously
  • is worried and cries a lot
  • have a cough and is hes
  • have respiratory problems.

Seek care directly at a health care center or emergency room for the child

  • have bloody or yellow-colored vomiting
  • has blood in the poo
  • seems very tired, does not make the same contact as usual and is uninterested in the surroundings
  • getting cramps.

You can seek care at any healthcare center you want throughout the country .

Investigations and investigations

The doctor may suspect that the child has gastroesophageal reflux disease after a detailed description of the symptoms. The symptoms can also be because the child eats something they are allergic to, for example cow’s milk. You can then try to exclude what you suspect the child cannot tolerate. It always happens in consultation with a doctor or a dietician. If the symptoms disappear, the child’s reflux may be due to the child not tolerating certain foods.

Sometimes it is measured how often the stomach contents appear in the esophagus and how long it is acidic. The measurement is done with an equipment that can measure pulsations and movement of the esophagus, called impedance measurement. A thin tube is placed in the esophagus. The measurement goes on for a day and does not hurt.

The child is given sedative medication when the tube is placed. The tube is placed in place through the nose or mouth using x-ray. The parents write in a diary when and what the child ate, how they slept, other activities and if the child had any symptoms. The child and the parents can either stay in the hospital or be at home during the day when examined.

If the problems with reflux are very severe, the mucous membrane of the esophagus can become irritated and ulcers can be formed. The esophagus can also become less elastic. The doctor can detect this by looking into the esophagus and stomach with a narrow, flexible instrument, called a gastroscope. The study is called esophageal gastroscopy. The child is anesthetized while the examination is being done. In connection with the examination, the doctor may take small mucosal samples from the esophagus. The samples are then examined with a microscope to see if the mucosa is irritated.                      

The child may also be allowed to submit blood samples during the investigation.

Treatment

The first step is to give the child small and dense meals. If the baby gets scabies, the scum can be made more fluid. Then it does not come up easily in the esophagus.

There are breast milk replacements  that become viscous as they descend into the stomach. There are also non-prescription products that blend directly with breast milk replacement and make it more liquid.

The child is given medicines that reduce the formation of acid in the stomach, if the esophagus is or is suspected to be irritated. The vast majority of children, regardless of age, get better from treatment.

If the child has very severe problems, the upper abdominal closing function can be improved with surgery. Such an operation may be relevant for individual children.  

More about gastroesophageal reflux disease

Children up to one year are often vomited after eating. This is because the upper abdomen is not fully developed when the baby is born. The stomach contents can then go back up to the esophagus and mouth after a meal, called gastroesophageal reflux. These small bills do not affect the child.

Some children are vomited more often and larger quantities. This is because the stomach mouth is so immature that its closing function does not work properly. The condition is then called gastroesophageal reflux disease.

Usually, the upper stomach mouth and its closing function develop and mature during the first year of life. Vomiting then decreases, and usually they disappear completely when the child is around one year. It is only in a few cases and in certain diseases that the vomiting may remain or recur after drug treatment.

Older children and adults may also have reflux problems .

It is estimated that between two and five percent of all infants have gastroesophageal reflux disease. It is more common in children with congenital brain damage, developmental disorders, such as Down syndrome, or as a sequelae after surgery of a congenital malformation of the esophagus.

Children’s participation in care

There is no age limit when a child is allowed to participate in a care situation. The child’s right to decide for himself is related to the child’s maturity. The older the child, the more important it is to be involved in his care.

In order to be active in health care and to make decisions, it is important to understand the information you receive from health care personnel. You can ask questions if you do not understand. You can also ask to have the information printed to read it peacefully. If interpretation is needed in other languages, you may have the right to have it. You may also have the right to receive interpreting assistance in the event of hearing loss .

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