Treatment for GER & GERD in Children & Teens

How do doctors treat GER and GERD in children and teens?

You can help control a child or teen’s gastroesophageal reflux (GER) or gastroesophageal reflux disease (GERD) by having him or her

How do doctors treat GERD in children and teens?

Depending on the severity of the child’s symptoms, a doctor may recommend lifestyle changes, medicines, or surgery.

Lifestyle changes

Helping a child or teen make lifestyle changes can reduce his or her GERD symptoms. A child or teen should

  • lose weight, if needed.
  • eat smaller meals
  • avoid high-fat foods
  • wear loose-fitting clothing around the abdomen. Tight clothing can squeeze the stomach area and push the acid up into the esophagus.
  • stay upright for 3 hours after meals and avoid reclining and slouching when sitting.
  • sleep at a slight angle. Raise the head of the child or teen’s bed 6 to 8 inches by safely putting blocks under the bedposts. Just using extra pillows will not help.
  • If a teen smokes, help them quit smoking and avoid secondhand smoke.

Over-the-counter and prescription medicines

If a child or teen has symptoms that won’t go away, you should take him or her to see a doctor. The doctor can prescribe medicine to relieve his or her symptoms. Some medicines are available over the counter.

All GERD medicines work in different ways. A child or teen may need a combination of GERD medicines to control symptoms.

Antacids

Doctors often first recommend antacids to relieve GER and other mild GERD symptoms. A doctor will tell you which over-the-counter antacids to give a child or teen, such as

Antacids can have side effects, including diarrhea and constipation. Don’t give your child or teen over-the-counter antacids without first checking with his or her doctor.

H2 blockers

H2 blockers decrease acid production. They provide short-term or on-demand relief for many people with GERD symptoms. They can also help heal the esophagus, although not as well as other medicines. If a doctor recommends an H2 blocker for the child or teen, you can buy them over the counter or a doctor can prescribe one. Types of H2 blockers include

If a child or teen develops heartburn after eating, his or her doctor may prescribe an antacid and an H2 blocker. The antacids neutralize stomach acid, and the H2 blockers stop the stomach from creating acid. By the time the antacids wear off, the H2 blockers are controlling the acid in the stomach.

Don’t give your child or teen over-the-counter H2 blockers without first checking with his or her doctor.

Proton pump inhibitors (PPIs)

PPIs lower the amount of acid the stomach makes. PPIs are better at treating GERD symptoms than H2 blockers.2 They can heal the esophageal lining in most people with GERD. Doctors often prescribe PPIs for long-term GERD treatment.

However, studies show that people who take PPIs for a long time or in high doses are more likely to have hip, wrist, and spinal fractures. A child or teen should take these medicines on an empty stomach so that his or her stomach acid can make them work correctly.

Several types of PPIs are available by a doctor’s prescription, including

Talk with the child or teen’s doctor about taking lower-strength omeprazole or lansoprazole, sold over the counter. Don’t give a child or teen over-the-counter PPIs without first checking with his or her doctor.

Prokinetics

Prokinetics help the stomach empty faster. Prescription prokinetics include

Both these medicines have side effects, including

  • nausea
  • diarrhea
  • fatigue, or feeling tired
  • depression
  • anxiety
  • delayed or abnormal physical movement

Prokinetics can cause problems if a child or teen mixes them with other medicines, so tell the doctor about all the medicines he or she is taking.

Antibiotics

Antibiotics, including erythromycin, can help the stomach empty faster. Erythromycin has fewer side effects than prokinetics; however, it can cause diarrhea.

Surgery

A pediatric gastroenterologist may recommend surgery if a child or teen’s GERD symptoms don’t improve with lifestyle changes or medicines. A child or teen is more likely to develop complications from surgery than from medicines.

Fundoplication is the most common surgery for GERD. In most cases, it leads to long-term reflux control.

A surgeon performs fundoplication using a laparoscope, a thin tube with a tiny video camera. During the operation, a surgeon sews the top of the stomach around the esophagus to add pressure to the lower end of the esophagus and reduce reflux.

The surgeon performs the operation at a hospital. The child or teen receives general anesthesia and can leave the hospital in 1 to 3 days. Most children and teens return to their usual daily activities in 2 to 3 weeks.

Endoscopic techniques, such as endoscopic sewing and radiofrequency, help control GERD in a small number of people. Endoscopic sewing uses small stitches to tighten the sphincter muscle. Radiofrequency creates heat lesions, or sores, that help tighten the sphincter muscle. A surgeon performs both operations using an endoscope at a hospital or an outpatient center, and the child or teen receives general anesthesia.

The results for endoscopic techniques may not be as good as those for fundoplication. Doctors don’t use endoscopic techniques.

References

April 2015
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This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings through its clearinghouses and education programs to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.