Topic Overview

What is gastroesophageal reflux?

Gastroesophageal reflux happens when food and stomach acid flow from the stomach back into the esophagus. The esophagus is the tube that carries food from the mouth to the stomach. In adults, reflux is often called heartburn or acid reflux.

Reflux is common in babies and children, and it is usually not a sign of a serious problem. Most babies stop having reflux around 1 year of age. A child who continues to have reflux may need treatment.

What causes reflux?

Reflux happens because of a problem with the ring of muscle at the end of the esophagus. The ring of muscle is called the lower esophageal sphincter, or LES. The LES acts like a one-way valve between the esophagus and the stomach. When you swallow, it lets food pass into the stomach. If the LES is weak, stomach contents can flow back up into the esophagus.

In babies, this problem happens because the digestive tract is still growing. Reflux usually goes away as a baby matures.

What are the symptoms?

It is common for babies to spit up (have reflux) after they eat. Babies with severe reflux may cry, act fussy, or have trouble eating. They may not sleep well or grow as expected.

An older child or teen may have the same symptoms as an adult. He or she may cough a lot and have a burning feeling in the chest and throat (heartburn). He or she may have a sour or bitter taste in the mouth.

If stomach acid goes up to the throat or into the airways, a child may get hoarse or have a lasting cough. Reflux can also cause pneumonia or wheezing, and it may hurt to swallow.

How is reflux diagnosed?

To find out if a child has reflux, a doctor will do a physical exam and ask about symptoms. A baby who is healthy and growing may not need any tests. If a teen is having symptoms, the doctor may want to see if medicines help before doing tests.

If a baby is not growing as expected or treatment doesn't help a teen, the doctor may want to do tests to help find the cause of the problem. Common tests include:

• A barium swallow, which is a series of X-rays that shows the esophagus and stomach.
• Endoscopy, which lets the doctor look at the esophagus.
• An esophageal pH test, which measures how much acid is in the esophagus.