Gastroesophageal Reflux Disease

Signs and Symptoms of Gastroesophageal Reflux Disease

Reflux occurs when the sphincter (muscle) between the esophagus and stomach doesn’t work properly, allowing stomach acids to back up into the esophagus and causing a burning or heart burn sensation. In non-verbal children this may lead to range of behaviors after feedings:

• Obvious discomfort and irritability, including screaming, posturing and arching
• Coughing
• Spits of formula or food accompanied by coughing

Gastroesophageal reflux disease (GERD) is especially difficult to diagnose in young non-verbal children. But if left untreated, chronic reflux can cause serious complications. Inflammation of the esophagus from refluxed stomach acid can damage the lining and cause bleeding or ulcers, also called esophagitis. Scars from tissue damage can lead to strictures (a narrowing of the esophagus) that make swallowing difficult.

There are medications and many non-invasive options for managing reflux and delayed gastric emptying. In severe cases, your doctor may recommend surgical intervention.

Lessons Learned

• GI studies can be misleading and subject to interpretation. Reflux doesn’t happen on command during a GI study.
• Follow your gut instincts. A parent knows their child better than anyone. If you suspect something is wrong, then you probably have cause for concern and you need to persevere until you get answers.
• You are your child’s only voice. Keep a journal and take note of feeding regiments, times, volume of intake and description, time and duration of any adverse behaviors you may witness that make you suspect reflux or other GI issues. A journal may show a pattern and will help give your doctor insight.
• Consider making a video of what you see, again, to help the doctor understand what you and your child are experiencing.

The bottom line? You are your child’s best advocate. If you think there’s something wrong, don’t stop asking questions and challenging your doctor. They are not always right.