Gastroesophageal Reflux Disease (GERD) in Children

What is GERD?

Gastroesophageal reflux disease (GERD) is a chronic digestive disorder that happens when acidic or non-acid stomach juices, food or fluids back up into the esophagus. GERD is a more serious form of gastroesophageal reflux (GER), also known as acid reflux or heartburn.

Spitting up is a normal occurrence for young infants. As long as your child is growing well and not developing other problems, such as breathing difficulties, the condition needs no treatment and will resolve on its own with time. 

However, GERD is considered serious when your child has:

  • frequent vomiting that results in poor weight gain and growth
  • inflammation (esophagitis) or ulcers (sores) form in the esophagus due to contact with stomach acid
  • ulcers that become painful and bleed, leading to anemia
  • respiratory problems

What causes GERD?

GERD in babies is generally the result of a poorly coordinated gastrointestinal tract, and most infants grow out of the condition by the time they reach 12 to 14 months.

In older children and teenagers, GERD is caused by an unexpected weakening or relaxing of the lower esophageal sphincter, which causes the stomach contents to build up in the esophagus. This may occur for a variety of reasons:

  • abdominal pressure from being overweight
  • certain medications, such as those used to treat asthma, allergies or pain
  • second-hand smoke or smoking

 A child or teen also may develop GERD from:

  • developmental delays or neurological conditions, such as cerebral palsy
  • a previous esophageal surgery

What are the symptoms of GERD?

The symptoms of GER and GERD can vary from “spitting up” to severe difficulties with vomiting, esophageal inflammation, pain and lung problems.

Each child may experience GERD differently. Common symptoms include:

  • belching
  • refusal to eat
  • stomachache or pain when eating
  • fussiness around mealtimes
  • hiccups
  • gagging or choking
  • frequent cough and/or coughing fits at night
  • wheezing
  • frequent ear infections
  • rattling in the chest
  • vomiting
  • heartburn
  • inability to gain weight
  • GI bleeding

How we care for GERD

At Boston Children’s Hospital, we treat the most difficult cases of GER and GERD. Our team will get to the root of your child’s reflux using sophisticated tests and a team approach to care. We also specialize in the evaluation and treatment of children with GERD that have undergone previous surgical procedures to control the reflux (fundoplication) and continue to have problems after surgery.