What Causes GERD in Children? – Heartburn, or acid reflux, seems like the bane of a middle-aged adult’s digestive system that keeps one from enjoying spicy or acidic food. The full name for the condition is gastroesophageal reflux disease, or GERD. Although it develops in adults most often, children are not immune. Knowing some of the most common causes enables more effective treatment of GERD in children.
What is GERD?
GERD is a condition caused by stomach acid flowing backward into the esophagus. Stomach lining consists of mucus to neutralize the acid so it does not damage the walls of the stomach as it breaks down food. At the bottom of the esophagus is a muscle called the esophageal sphincter (LES). It acts as a one-way valve so food can travel downward, but acid cannot travel back up. This muscle sometimes malfunctions and causes reflux.
The presence of GERD comes down to two main factors: a weak or damaged LES or the excess production of stomach acid, or some combination of the two. By no means are all cases of GERD due to these two causes, but the majority are.
Weakened LES
The lower esophageal sphincter is often weaker in children who overeat frequently because the stretching of the stomach puts stress on the membranes of the LES and prevents it from staying fully closed. Also, too much food in the stomach can displace the acid, forcing it upward.
Cigarette smoke, as well, can weaken the LES because it has numerous toxic chemicals. Therefore, second-hand smoke can be a contributing factor. Limiting or eliminating this can reduce the child’s likelihood of developing GERD.
Infants have weaker muscles in general. In this case, the LES relaxes when it shouldn’t and does not prevent food or milk from causing GERD.
One thing to note is that everyone has acid reflux sometimes, especially infants. After the first year of life the stomach muscles have usually developed enough to prevent it from becoming a chronic issue, which is what differentiates acid reflux from full-on GERD.
Excess Stomach Acid
Even if the LES functions as it should, it can still be overwhelmed if the stomach produces too much acid. Certain foods and drinks trigger this reaction. For example, fried foods or high-fat foods take a longer time to digest and require more effort. Carbonated beverages and foods that naturally have a high acid content increase the acidity of the stomach.
Slowed digestion contributes to GERD partially because of more food in the digestive tract or stomach bloating. Spicy foods, such as salsa, contain capsaicin which is thorught to slow digestion. Incidentally, this is why you often might feel bloated after a tasty Mexican dish. Whether horseradish/mustard has the same effect is currently unknown. Although these foods are spicy, the mechanism is slightly different.
Another culprit, much to many children’s dismay, is chocolate. Chocolate stimulates the body into secreting serotonin and causes the LES to relax.
Eating Too Quickly
IF a child, or anyone for that matter, eat too quickly (i.e., doesn’t chew food), then saliva and chewing don’t break food down into small enough pieces for the stomach to do its job effectively. Large chunks of food take longer to digest and stimulate the overproduction of hydrochloric acid, contributing in turn to GERD.
Hypertrophic Pyloric Stenosis
Just as the lower esophageal sphincter can malfunction, so too can the passage leading from the stomach into the small intestine, or the pylorus. the digested remnants of food that go into the small intestine pass through the pylorus, but cannot pss backwards.
When this muscle is overdeveloped, food cannot pass out of the stomach at a regular rate and it slows the digestive process even if GERD-causing foods are diligently limited. This condition is more common in males, infants who were fed on infant formula, or in babies with a family history of pyloric stenosis.
Peptic Ulcer
An ulcer is a weak spot in the walls of the stomach. A peptic ulcer is often caused by a specific bacteria known as Helicobacter pylori. This bacteria can be passed by skin-to-skin contact of unwashed hands after a bowel movement. Improper dental hygiene can lead to this infection as well, because the bacteria resides in tooth plaque.
How is GERD Diagnosed?
Some of the most common symptoms of GERD are excessive or forceful vomiting, persistent heartburn, discomfort in the stomach or chest, chest pains, and hoarseness. While most of these symptoms are obvious, the hoarseness can occur because of stomach acid coming up into the vocal cords and creating scar tissue or inflammation.
While chest pain is a symptom of GERD, it’s also something that should be taken seriously, especially if it occurs along with difficulty breathing. The doctor will be able to determine whether the condition is GERD or something even more serious.
GERD can, if left untreated, lead to complications like serious stomach ulcers. It’s important to treat this condition as soon as possible.
Testing for GERD
The main way of determining whether a child has GERD is by performing an endoscopy. A thin tube with a camera is threaded down the throat so the doctor can view the esophagus to determine if inflammation has occurred. In these cases, scar tissue will likely form near the bottom of the esophagus. Another method of testing for GERD is a barium scan. The child eats food with a small amount of slightly radioactive material, which allows X-rays of the esophagus. For advanced diagnosis, a CT (computed tomography) scan may be needed.
Getting Checked
Your child does not have to suffer from gastroesophageal reflux disease. It can take time to get a checkup, but if you want to diagnose GERD in New Jersey, there are resources available.
