Gastroesophageal refers to the
stomach and esophagus. The esophagus is the tube that connects the throat to the
stomach. Reflux means to flow back or return. Reflux happens because the lower
esophageal sphincter in babies opens easily. This allows the acidic stomach juices,
food, and fluids to flow back into your child’s esophagus.
Reflux can happen at any age, but
it’s common in babies. It is usually a temporary problem. But if it becomes a long-term
problem, it is called gastroesophageal reflux disease (GERD).
Reflux is often caused by problems with the lower esophageal sphincter. This is a muscle at the bottom of the esophagus. Normally, it opens to let food into the stomach and closes to keep food in the stomach. When this muscle relaxes too often or for too long, acid goes back into the esophagus. This causes nausea, vomiting, and heartburn.
As babies digest their food, the
lower esophageal sphincter may open. This lets stomach contents go back up into your
child’s esophagus. Sometimes the contents go all the way up. This causes your baby to
vomit. Sometimes acid or material can pass into the windpipe (trachea) and cause
coughing or infection. Other times, the contents may only go part of the way up the
esophagus. This can cause heartburn or breathing problems. Or it may not cause
Symptoms can occur a bit differently in each child. They can include:
The symptoms of this condition may
be similar to symptoms of other health problems. Have your child see his or her
healthcare provider for a diagnosis.
Your child’s healthcare provider
will examine your child and check his or her health history. Your child may need the
following tests to diagnose reflux.
A chest X-ray is done to look for signs of aspiration. Aspiration happens when the stomach contents spill into the lungs. This causes breathing problems and lung infections.
An upper GI series looks at the
organs in the upper part of your child’s digestive system. These include the
esophagus, stomach, and the first section of the small intestine (duodenum). For this
test, your child will swallow barium. This is a metallic liquid that coats the inside
of their organs. This helps them show up on an X-ray. Then your child’s healthcare
provider will take an X-ray of these organs.
In this test, a small, flexible
tube (endoscope) is used to look at the inside of your child’s digestive tract. This
tube has a light and a camera lens at the end of it. During the test, your child may
have tissue samples removed from their digestive tract. Your child’s healthcare
provider will test these samples.
This test measures the level of acidity in your child’s esophagus.
This test will show if your
child’s stomach contents empty into their small intestine the correct way. Delayed
gastric emptying can cause reflux.
Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.
Most babies with reflux have no symptoms other than spitting up often. As long as these children grow well and don’t have other issues caused by reflux, they don’t need treatment.
Sometimes reflux can be managed with feeding changes. These changes should be made under the care of your baby’s healthcare provider. These can include:
Your baby may need reflux medicine. These medicines can decrease the amount of acid the stomach makes. This will ease the heartburn caused by reflux.
Some babies with reflux may vomit often. This can keep them from gaining weight. In this case, your baby’s healthcare provider may suggest the following:
Some babies with reflux have other conditions that make them tired. These can include heart disease or being born premature. These babies may not be able to eat much before getting sleepy. Other babies can’t keep a normal amount of formula or breastmilk in their stomachs without vomiting. These babies may do better if they eat a small amount of food continuously.
In these cases, your child’s healthcare provider may recommend tube feedings. A tube is placed in your child’s nose and guided through the esophagus and stomach. This is called a nasogastric tube. These tubes can also be used to bypass the stomach if needed. Tube feedings can be done with or in place of bottle-feeding or breastfeeding.
In severe cases, your child may need surgery. This surgery is done to reinforce the lower esophageal sphincter. This helps keep the reflux from happening.
Some babies with reflux may not vomit. Instead, their stomach contents may move up and spill over into the windpipe (trachea). This can cause wheezing and pneumonia. In rare cases, this can be life-threatening.
Babies with reflux who vomit often
may not gain weight and grow normally. This can cause inflammation (esophagitis) or
sores (ulcers) in the esophagus. These ulcers can be painful. They may also bleed. This
can lead to anemia. This means too few red blood cells in the bloodstream. Over time,
this may cause long-term problems. These can include esophageal narrowing (stricture)
and abnormal cells in the lining of the esophagus (Barrett’s esophagus).
Many babies with reflux will outgrow it by the time they are age 1. This is when the lower esophageal sphincter becomes stronger. For other babies, feeding and lifestyle changes and medicine can help. Work with your child’s healthcare team to create a care plan for your child.
Call your child’s healthcare provider if your child vomits after every feeding or has new reflux symptoms.
Tips to help you get the most from a visit to your child’s healthcare provider:
The University of Chicago Medicine
5841 S. Maryland Avenue
Chicago, IL 60637 | 773-702-1000
Appointments: Call UCM Connect at 1-888-824-0200