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   GERD (Gastro-esophageal reflux disease)  
 
  Gastro-esophageal reflux disease or acid-reflux disease is a condition in which the contents of the stomach reflux backwards into the esophagus (food pipe). Since the stomach contents are acidic in nature, this damages the inner lining of the food pipe and causes symptoms of heartburn, pain, etc.
Some amount of reflux of stomach contents is normal in all individuals but not everyone develops GERD. The main reason behind this is that only in some individuals this refluxed fluid is more acidic and remains in the esophagus for longer duration thus causing GERD. Dietary causes and certain faulty habits are frequently responsible for initiating this condition in individuals who are prone to develop it.
At the junction of the food pipe (esophagus) and the stomach is a muscular gateway (called lower esophageal sphincter or LES). Under normal circumstances, this sphincter remains contracted so that no contents of the stomach can go back into the esophagus but when this sphincter becomes relaxed due to any reason or is weak, it may allow the contents of the stomach to flow back into the esophagus causing inflammation of the lining of the oesophagus. There can also be many other causes of GERD which will be discussed in details later.
Gerd in Childen

GERD is not an uncommon disorder amongst infants but this diagnosis is frequently missed out due to the fact that spitting up after a meal is a common occurrence in children. However, this is a difference between spitting up after a meal and the symptoms of GERD. If the parents are able to observe that their infant possibly has symptoms that are not normal, they will seek treatment well in time.

GERD causes upward movement of the contents of the stomach (food+acid) into the food-pipe (esophagus) of the child, sometimes into or out of the mouth.

Causes of GERD in children
Symptoms of GERD
Consult your health care provider when following occurs
Diagnosis of GERD in children
Treatment of GERD in children

Causes of GERD in children:
A poorly coordinated gastro-intestinal tract is the commonest cause of GERD in children. An immature digestive system is the prime reason for this complaints and this is precisely why most of the infants outgrow this condition by the time they complete 1 year of age.
The causes of GERD in older children are predominantly the same as the causes of GERD in adults.
Certain other factors that may contribute to GERD include obesity, overfeeding, certain medications, etc. There also appears to be an inherited component to GERD, as it is more common in some families than in others.

Symptoms of GERD:
The common symptoms of GERD in children are as follows:
Recurrent vomiting
Frequent or persistent cough
Refusing feeds or notable difficulty in eating
Choking or gagging during feeds
Older children may complain of heartburn, abdominal pain, gas
Infants may demonstrate colicky behavior (frequent crying and fussiness).
Regurgitation and re-swallowing
Severe cases may lead to any of the following in the long run:
Poor growth
Breathing problems
Recurrent pneumonia

Consult your health care provider when following occurs
Large or persistent vomiting, particularly in infants under 2 months of age
Vomiting of fluid that is greenish, yellowish, appears like grounded coffee or blood
Difficult breathing associated with vomiting or spitting up
Excessive irritability related to feeding
Weight loss or poor weight gain associated with refusal to feed.
Difficult or painful swallowing
Diagnosis of GERD in children:
In most of the cases, the history given by the parents is sufficient enough to diagnose this condition. Repeated recurrence of the above-mentioned complaints and visible distress of the child are adequate for diagnosis.

However, following tests can be conducted to confirm the diagnosis
Upper GI endoscopy
Barium swallow
Gastric emptying study
Esophageal pH probe

Treatment of GERD in children:
Most babies outgrow GERD by the time they complete one year of age. However, even during this period, proper treatment must be administered to ensure that the complaints do not worsen. For children in whom this condition persists beyond one year of age, the treatment gives significant relief from distress and also controls the progress of the complaints. Click here to read about the Homoeopathic treatment of GERD in children. Please note that the principles of treatment largely remain the same as in adults. However, certain additional life-style changes are suggested for infants for better control of the symptoms:

Elevate the head end of the baby's crib
Hold the baby upright for at least 30 minutes after a feed.
Burp feeding on each side.
Try several short feeds frequently rather than one large feed
With the approval of your doctor, introduce semi-solid foods into the diet of your infant
Avoid over-feeding the child at any time
Older children should not be allowed to lie down for at least 2 hours after meals
Limit foods that you think worsen your child's complaints

 
 
 
     
 
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