GAsTROesOPHAGeAL ReFLuX DIseAse Is A CHRONIC DIGesTIve DIsORDeR, WHICH AFFeCTs MANy CHILDReN (As WeLL As ADuLTs) IN THe uNITeD kINGDOM.
A comprehensive guide to
GERD G
astroesophageal reflux disease (GeRD) is a long- lasting form of the more
common gastroesophageal reflux (GeR).
GER or GERD?
GeR is a normal process that can happen to infants, children and adults after eating in healthy infants, children, young people and adults and occurs when the contents of the stomach flow back up – or reflux – into the esophagus.
Babies are particularly affected by GeR, since most babies will spit food up a few times a day during the first three months of their lives. In most instances GeR will not cause any problems for babies, with most outgrowing the condition by the time they’re about a year old.
GeRD, on the other hand, occurs when the effect of GOR leads to symptoms severe enough to merit medical treatment.
unfortunately, it can be difficult to differentiate between GOR and GORD, mainly because there is no simple, reliable and accurate diagnostic test to confirm whether a person is experiencing one or the other and, in fact, many healthcare professionals use the terms interchangeably.
Symptoms
Heartburn, or acid indigestion, is the most common symptom of GeRD. This generally presents as a burning chest pain, which begins behind the breastbone and moves up to the neck and throat.
Heartburn can last as long as two hours and is often made worse by eating, although lying down or bending over after a meal can also exacerbate it.
Children under the age of twelve may not, however, have ‘classic’ heartburn and may experience different GeRD symptoms, such as a dry cough, asthma symptoms, or difficulty in swallowing.
Other common symptoms of GeRD include: • Burping or belching • Reluctance to eat • stomach pain • Frequent vomiting • Hiccupping • Choking • Frequent coughing • Night-time coughing fits
While babies can be particularly affected by GeR, it is also common for children and teenagers aged between two and 19 to experience the condition periodically and does not necessarily signify that they have GeRD.
Other, less frequent symptoms may include: • Wheezing • Frequent colds and ear infections • A ‘rattling’ in the chest • A sore throat in the morning • A sour taste in the mouth • Bad breath
GeRD symptoms can often be linked to other health problems, so it’s important that a healthcare provider examines a child to ascertain to what degree the symptoms are those of GeR or GeRD.
Many babies and children with GeRD can experience frequent vomiting and so this can cause problems with weight gain and poor nutrition. Also, when stomach acid regularly flows back up into the esophagus, it can lead to: • Inflammation of the esophagus (esophagitis)
• sores or ulcers in the esophagus • A lack of red blood cells from bleeding sores (anemia)
Healthcare professionals will often determine that a baby or child has GeRD if they have experienced GeR for more than twelve to fourteen months or have experienced GeR more than twice a week for a few months.
Causes
so what actually causes GeRD? Well, GeRD is often caused by something that affects the lower esophageal sphincter (Les), which is a muscle at the bottom of the food pipe (esophagus). The Les opens up, enabling food to enter the stomach and closes to keep the food in the stomach. If, however, the Les relaxes too often or for too long, stomach acid flows back into the esophagus, causing vomiting or heartburn. Babies can often have a weak Les and this means that it relaxes and opens when it should actually remain closed. If the Les opens when the baby is digesting its food or milk, the stomach contents flow back up to the esophagus. sometimes all of the stomach contents will flow back up to the esophagus and the baby will vomit. On other occasions, the stomach contents will only go part of the way up and this can cause heartburn or breathing problems. some foods seem to affect the muscle tone of the Les more than others. These include: • Chocolate • Peppermint • High-fat foods
Other foods such as citrus foods, tomatoes and tomato sauces can also bring on symptoms because they are acidic.
> PHARMACy IN FOCus - 23
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