Kids that Get Heartburn?

When I was a lot younger and not quite prone to really thinking about what I was doing, I would wolf down a dozen or so White Castle hamburgers (this was back in the day when they cost 12 cents a piece) I'd pour enough salt and ketchup to choke a horse and then proceed to feel like my stomach and chest was on fire. Trust me when I tell you heartburn in a child is not a good thing. I sure didn't know it then, but I know it now, that the burning sensation, or heartburn, is one symptom of Gastro-Esophageal Reflux Disease or GERD. GERD symptoms occur in about 2% to 22% of children between the ages of 3 and 18.

According to the Children's Digestive Health and Nutrition Foundation (www.cdhnf.org), GERD happens when acid and food flow back up from the stomach and into the esophagus (the tube that connects the mouth to the stomach), potentially damaging the esophagus and causing chronic respiratory and other health problems.

Meanwhile, a study in The American Journal of Gastroenterology (www.amjgastro.com) points out that children with GERD are also at risk for having GERD as an adult.

So what causes Gastro-Esophageal Reflux Disease? GERD is caused by the weakening of a muscle called the lower esophageal sphincter (LES). When you swallow, it contracts to prevent stomach contents from flowing back up, or regurgitating, into the esophagus. Certain foods, medications, and conditions can relax the LES, allowing acid to regurgitate.

The American College of Gastroenterology (www.acg.gi.org) recommends that your child avoid the following foods and beverages if he/she has GERD:

- Spicy, acidic, or tomato-based foods

- Fatty foods

- Citrus products (e.g., orange juice)

- Apple juice (apples are fine)

- Chocolate and licorice

- Caffeinated drinks (e.g., soda, coffee, tea, hot chocolate)

According to the International Foundation for Functional Gastrointestinal Disorders (www.aboutgerd.org), researchers have also considered whether milk might contribute to GERD. A study published in 2004 in the Journal of Pediatric Gastroenterology and Nutrition found an association between GERD and cow milk allergy in children. The study found that among 18 children with severe GERD, 10 were also allergic to cow's milk. These same 10 had a significantly higher reflux index (a measurement of reflux severity) compared to those not allergic to cow's milk.

HealthLibrary.com points out that symptoms of GERD in children include:

- Severe abdominal discomfort

- Lower chest pain

- Heartburn

- Sensation of food or liquid regurgitating into the throat or mouth

- Sensation of food stuck down in the throat

- Difficulty or pain while swallowing

- Hoarseness

- Vomiting

Fortunately for me, the effect of all those White Castle burgers on me limited only to heartburn. But in retrospect -- you never know.

According to the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (www.naspghan.org), GERD can usually be diagnosed based on your child's symptoms and a physical exam. Additional diagnostic tests are not often required. Once the diagnosis is made, it can be treated through lifestyle changes, medication, and surgery.

Changing your child's diet may relieve mild symptoms. Avoiding GERD "trigger" foods (listed previously) may be the first step. The doctor may also suggest feeding your child smaller meals and avoiding food 2-3 hours before bedtime. Finally, elevating your child's head at a 30 degree angle and having him or her sleep on their left side may also ease symptoms.

The Children's Digestive Health and Nutrition Foundation explains that there are three classes of prescription medications to treat GERD: H2-blockers, proton pump inhibitors (PPIs), and prokinetic agents. H2-blockers and PPIs decrease the amount of acid in the stomach, while prokinetic agents strengthen the LES. Although there are some over-the-counter antacid medications that treat adult GERD, doctors do not recommend them for children.

GERD can be an uncomfortable condition for both you and your child. But there is help available. Recognizing and relieving your child's symptoms now may benefit his or her health down the line.

Kids tend to eat like horses at times, as a parent it's a good idea to keep an eye out not only what your children are eating, but what effect certain foods have on your child's digestion.