Signs and Symptoms and Diagnosis for Teens

Gastroesophageal Reflux (GER) occurs when stomach contents go up into the esophagus (the tube that connects the mouth to the stomach), during or after a meal. In some children, the stomach contents go up the mouth (regurgitation) and are swallowed again. Other symptoms include hoarseness, recurrent pneumonia, cough, wheezing and difficulty or painful swallowing.

The doctor or nurse can talk with you about your child’s symptoms, do a physical examination and recommend tests to determine if reflux is the cause of symptoms. These tests check the esophagus, stomach and small intestine to see if there are any problems. However, treatment is sometimes started without the need for any tests. Common tests are:

* Barium (a chalky drink) is swallowed and X-rays show the shape of the esophagus and stomach. This test can find a hiatal hernia, blockage and other problems.
* Endoscopy: After the patient is given a sedative medication so they are asleep, a small flexible tube with a very tiny camera is inserted through the mouth and down into the esophagus and stomach. The lining of the esophagus, stomach and part of the small intestine can be examined and biopsies (small pieces of the lining) can be painlessly obtained. The biopsies can later be examined with a microscope, looking for inflammation and other problems
* Esophageal pH Probe: A thin light wire with an acid sensor at its tip is inserted through the nose into the lower part of the esophagus. The probe can detect the amount of stomach acid coming up into the esophagus and can tell if there acid in the esophagus.

Worrisome Symptoms of Reflux Disease in Children

(2 - 12 Years Old) (Symptoms experienced by your child.)
1. Repeated vomiting associated with
Blood
Green or yellow fluid
Weight loss or poor weight gain

2. Frequent sensation of food or liquid coming up into the back of the throat or mouth

3. Frequent discomfort in the stomach or chest

4. Swallowing problems
* Discomfort with the act of swallowing
* Pain with swallowing
* Sensation that food gets stuck on the way down

5. Breathing Problems
* Wheezing
* Chronic cough or recurrent pneumonia
* Hoarseness
* Asthma

If you have concerns, speak to your healthcare provider.

WHAT’S UP WITH MY KID’S STOMACH?

Reflux and your Child (2 -12 year olds)
Gastroesophageal Reflux (GER) occurs during or after a meal when stomach contents go back into the tube that connects the mouth to the stomach. Most children are able to decrease their reflux with lifestyle and diet changes:

* Have your child eat smaller meals more often
* Avoid eating 2 to 3 hours before bed time
* Avoid carbonated drinks, chocolate, caffeine, and foods that are high in fat (french fries and pizza) or contain a lot of acid (citrus, pickles, tomato products) or spicy foods.
* Avoid large meals prior to exercise
* Help your child lose weight if they are overweight
* Avoid exposure to tobacco smoke
*
Elevate the head of the bed 30 degrees

Most children with GER will be helped with the treatment mentioned above. If symptoms are severe or persistent then your primary care provider may consider treatment with a medication or referral to a pediatric gastroenterologist.