Skip Ribbon Commands
Skip to main content
Skip Navigation LinksBoys Town Pediatrics > Knowledge Center > Health Articles > GERD in Children

GERD in Children

By Anna Trauernicht, M.D.

Gastroenterologist examining toddler stomach

​Gastroesophageal reflux disease (commonly known as GERD) is a chronic digestive condition that affects 25 percent of children and teens, according to the National Institutes of Health.

Complications from GERD rarely cause significant harm, but symptoms can interfere with daily life. For this reason, parents may find it helpful to be aware of the differences of reflux and GERD and what to do if your child suffers from the disease.

What is the difference between GERD and Reflux?

Symptoms of reflux are similar to those of GERD; and the symptoms of both conditions are brought on by stomach acid re-entering the esophagus as a result of a weakened or abnormally relaxed sphincter muscle. However, if your child has reflux that doesn't necessarily mean that he/she has GERD.

What separates reflux from GERD is the frequency of the symptoms. GERD is diagnosed when a child consistently experiences acid reflux or heartburn more than two times a week.

GERD Symptoms

Symptoms of GERD include:

  • Burning or painful sensation in the chest
  • Difficulty swallowing
  • Dry cough
  • Hoarseness
  • Sore throat
  • Feeling of a lump in the throat
  • Regurgitation of food or a sour liquid

Children with GERD occasionally show additional symptoms including:

  • Nausea or frequent vomiting
  • Continued struggle with spit up after age 1
  • Irritability after eating
  • Refusal to eat or only eating in small amounts
  • Failure to gain weight
  • Choking or wheezing
  • Bad breath

What to do if Your Child has GERD Symptoms

If you think your child is suffering from GERD, set up an appointment with your pediatrician. The pediatrician will assess your child's symptoms and situation and refer you to a gastroenterologist if he/she feels that your child would benefit from specialty care.

GERD Treatment

There are a variety of treatments available to minimize GERD symptoms. Your physician will likely have your child go through a list of options until finding the one that works best.

The first treatment option is to make lifestyle changes. Changes that your physician might suggest for your child include:

  • Sleeping at a slight incline
  • Avoiding tight clothes
  • Avoiding eating two to three hours before bed
  • Avoiding giving your child common trigger foods – citrus fruit, garlic, spicy food, peppermint, chocolate, onions, tomato-based food and sauces, fatty/fried foods, food or drink containing caffeine

If lifestyle changes do not effectively improve symptoms, your doctor may suggest that your child begin taking over-the-counter (OTC) medication. Different types OTC medications will serve different purposes and can be used alone or in combination – with the approval of a pediatrician or gastroenterologist.

  • Antacids neutralize stomach acid, providing quick relief. However, this type of medicine will not heal the inflammation in the esophagus caused by chronic exposure to stomach acid.
  • H2 blockers reduce stomach acid production. This type of medicine doesn't go into effect as quickly as antacids do, but it can provide longer relief from GERD symptoms – up to 12 hours.
  • Protein pump inhibitors (PPIs) block acid production and help heal the esophagus from damage caused by stomach acid exposure.

If OTC medication does not sufficiently calm GERD symptoms, your physician may suggest prescription medication. The functions are similar to the OTC medications listed above, but the prescription medication will be stronger, due to either increased dosage or differing active ingredients.

Finally, if none of the above treatments work, your physician may suggest surgery to either strengthen on reinforce the sphincter muscle, therefore keeping excess stomach acid from flowing back into the esophagus.