Reflux can occur at any age and in many different forms. Sometimes patients require medicine for a few weeks to treat reflux and sometimes treatment is needed for years. Some symptoms are easily associated with reflux and some symptoms are a little subtler. So this month, we are going to discuss how reflux can look and what treatment options may be available to each age group.
Every newborn has physiological reflux. This is normal, not harmful, and usually results in what we call “happy spitters.” Newborns are typically lying down more often and eat more frequently– so, naturally, they are going to spit up more often. For these infants, no medicine is usually required. However, it does help to sit them upright for about 30 minutes after feeding and burp frequently to help allow the stomach to empty enough to prevent a spit up incident.
Some newborns are incredibly fussy, squirmy and can start to refuse to eat due to spitting up. This is more than physiological reflux – this is what we call Gastroesophogeal Reflux Disease (GERD). This type of reflux usually indicates that some of the acid made in the stomach is probably coming up with the spit up and burning or damaging the esophagus. Medications are available from your pediatrician to reduce the amount of acid being produced so that the esophagus does not continue to be damaged. More severe cases may even need to be seen by a pediatric gastroenterologist, so discuss treatment options with your pediatrician if you suspect this is happening with your infant.
Reflux or GERD can look a little different in older children and adults. It is possible to have reflux symptoms at the toddler and elementary school age, but for some reason it is not seen as often in this group compared to older ages. Past the newborn stage, reflux can be triggered by certain food groups. Sometimes, simply avoiding fried and fatty foods, peppermint, chocolate, or even caffeine for a short period of time can be enough to stop the reflux.
In school-age children and adults, people with reflux often describe the sensation as burning in the chest, bad breath, frequent burps, or throwing up after eating. Occasionally, reflux can present as a persistent cough– without any other respiratory symptoms– which often prolongs the diagnosis.
Treatment in this age group may include medications, but sometimes simply eating smaller meals, avoiding food close to bedtime, not eating “heavy” foods that are known to cause reflux, or losing weight if necessary can be enough to relieve the symptoms. There are some over-the-counter medications that can be used to treat reflux; however, for children I would discuss these options with a pediatrician first, as the dosage may vary depending on a child’s age and weight. In adult-sized teenagers and adults, these over-the-counter medications may be valid options for treating symptoms, and in most cases shouldn’t require a conversation with a physician beforehand.
In most cases, reflux is a transient problem, and usually it does not cause permanent damage to the stomach and esophagus. Still, in some patients the symptoms may be more difficult to recognize or may be too severe to try and treat on your own. If you ever have concerns or questions about reflux in your child, don’t hesitate to ask your pediatrician what your first steps should be.