Gastroesophageal Reflux DiseaseAdolescent (GERDAdolescent, Chronic HeartburnAdolescent, Reflux EsophagitisAdolescent, Gastro

Risk FactorsUnlike infants and children, there are not many known risk factors for the development of GERD among adolescents. Obesity, a risk factor for adults, may also increase the risk of developing this condition among teenagers. Smoking and using alcohol may also put teens at risk. SymptomsIf your teen has any of these symptoms, do not assume it is due to GERD. These symptoms may be caused by other conditions. If your child has any of these, tell the doctor:HeartburnAbdominal or chest painRegurgitation VomitingNeed to clear throatBloody vomitBad breathDifficulty swallowingWorsening asthmaRecurrent pneumonia or respiratory problemsSore throatCough, wheezing, or hoarsenessDental problems (due to the effect of the stomach acid on the tooth's enamel) DiagnosisYour doctor will ask about your teens symptoms and medical history, and perform a physical exam. Your child may need to see a gastroenterologist, a doctor who specializes in gastrointestinal diseases.Tests may include:Upper GI seriesa series of x-rays of the upper digestive system taken after drinking a barium solutionUpper endoscopy with biopsya tube is inserted into esophagus to look at the lining and a piece of tissue is taken for testing24-hour pH monitoringa probe is placed in the esophagus to keep track of the level of acidity in the lower esophagusShort trial of medicine TreatmentTalk with your doctor about the best treatment plan for you. Treatment options include the following:

Lifestyle ChangesBefore recommending medication, your teen's doctor may suggest lifestyle changes. These may include:Eating smaller, more frequent mealsAvoiding late night snacksSleeping on the left sideAvoiding certain foods, such as:ChocolateFried foodsPeppermintSpicy foodsCaffeine productsCarbonated beveragesFoods high in fat and acidIf your teen is obese, your doctor may recommend weight loss. Also, talk to your teen about smoking and alcohol, which can worsen GERD symptoms. MedicationsMedications may include:Histamine-2 receptor drugsto decrease acid production (eg, Tagamet, Pepcid, Zantac)Proton pump inhibitorsto heal the esophagus lining and relieve symptoms (eg, Prilosec, Prevacid, Protonix, Nexium)Promotility drugsto help slow stomach emptying (eg, Reglan)Over-the-counter antacidsto treat heartburn relief (eg, Tums, Maalox)Many of these are over-the-counter medications. Talk to your teen's doctor about any new medication. SurgeryIn severe cases, the doctor may recommend surgery. The most common treatment is called fundoplication. During this procedure, the surgeon wraps part of the stomach around the lower esophageal sphincter. This makes the sphincter stronger and prevents stomach acid from backing up into the esophagus.

PreventionWhile some of the causes of GERD in adolescents are unknown, your teen can take these steps to control the condition:Following the doctor's dietary and lifestyle changesAvoiding smoking and second-hand smokeAvoiding drinking alcoholKeeping a diary of symptoms RESOURCES: Childrens Digestive Health and Nutrition Foundationhttp://cdhnf.org/ National Digestive Diseases Information Clearinghouse (NDDIC)http://digestive.niddk.nih.gov/index.htm CANADIAN RESOURCES: About Kids Healthhttp://www.aboutkidshealth.ca Canadian Digestive Health Foundationhttp://www.cdhf.ca/index.html References Dente K. Quick lesson about gastroesophageal reflux disease in children and adolescents. EBSCO Nursing Reference Center website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=16topicID=860. Accessed May 19, 2008. Gastroesophageal reflux disease (GERD). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Accessed May 19, 2008. Gastroesophageal reflux in children and adolescents. National Digestive Diseases Information Clearinghouse website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/gerinchildren/index.htm. Accessed May 19, 2008. GERD in children and adolescents. Childrens Digestive Health and Nutrition Foundation website. Available at: http://gerd.cdhnf.org/User/Docs/PDF/AdolesGERDFlier.pdf. Accessed May 19, 2008.

GERD in children with an underlying structural anomaly. Childrens Digestive Health and Nutrition Foundation website. Available at: http://gerd.cdhnf.org/User/Docs/PDF/CUSA_Brochure.pdf. Accessed May 19, 2008. Pediatric gastroesophageal reflux, clinical practice guideline summary. Childrens Digestive Health and Nutrition Foundation website. Available at: http://gerd.cdhnf.org/User/Docs/PDF/GERD_8_pg_brochure_031604.pdf. Accessed May 19, 2008. Pediatric GE reflux clinical practice guidelines. J Pediatr Gastroenterol Nutr. 2001;32:S1-S31. Last reviewed May 2008 by Kari Kassir, MDPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.