Treatment for GER & GERD in Children
How do doctors treat GER and GERD in children?
Doctors may recommend lifestyle changes or medicines to treat gastroesophageal reflux (GER) or gastroesophageal reflux disease (GERD) in children. In some cases, doctors may also recommend surgery.
Doctors may recommend lifestyle changes to reduce GER or GERD symptoms. Research suggests that certain lifestyle changes improve GERD symptoms in adults, but studies in children are limited.
Lifestyle changes your child’s doctor recommends may depend on your child’s age and symptoms. For example, doctors may recommend that children who have GERD
- sleep with their head elevated or sleep on their left side
- avoid eating just before they lie down or go to bed
- change their eating habits or diet
- avoid secondhand smoke or, if they smoke, quit smoking
If lifestyle changes don’t relieve your child’s GERD symptoms, your child’s doctor may prescribe medicines. Some GERD medicines are available over the counter. Don’t use over-the-counter or prescription medicines to treat your child’s GERD unless told to do so by your child’s doctor.
Proton pump inhibitors (PPIs). PPIs lower the amount of acid the stomach makes. PPIs are better at treating GERD symptoms and healing the esophageal lining than other medicines, such as H2 blockers. Doctors typically prescribe PPIs to treat GERD in children for 4 to 8 weeks.2 In some cases, doctors may prescribe PPIs for long-term treatment.
PPIs are generally safe and effective. Side effects of PPIs may include diarrhea, headache, or upset stomach. PPIs may increase the chance of getting certain types of infections. Experts are still studying the effects of taking PPIs for a long time or in high doses. Talk with your child’s doctor about the risks and benefits of PPIs.
H2 blockers. H2 blockers lower the amount of acid the stomach makes. H2 blockers can help heal the esophagus, but not as well as PPIs can. H2 blockers may cause side effects, such as abdominal pain, diarrhea, and headache, and may increase the chance of getting certain types of infections.
Antacids. In some cases, doctors may recommend short-term use of antacids to relieve mild GER and GERD symptoms in older children or teens. These medicines can have side effects, such as diarrhea or constipation. Doctors don’t recommend long-term use of antacids, which may lead to serious health problems.
Other medicines. If PPIs, H2 blockers, and antacids don’t improve a child’s symptoms, the doctor may recommend other medicines.
Doctors may recommend surgery to treat GERD in children if medicines and lifestyle changes don’t improve symptoms or if serious GERD complications occur. Children are 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 improvement of GERD symptoms. Surgeons most often perform fundoplication as laparoscopic surgery, making small cuts in the abdomen and inserting special tools to perform the operation. Laparoscopic fundoplication leaves several small scars. During the procedure, surgeons sew the top of the stomach around the end of the esophagus, which adds pressure to the lower esophageal sphincter and helps reduce reflux.
 Rosen R, Vandenplas Y, Singendonk M, et al. Pediatric gastroesophageal reflux clinical practice guidelines: joint recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition. Journal of Pediatric Gastroenterology and Nutrition. 2018;66(3):516–554. doi: 10.1097/MPG.0000000000001889
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