reflux esophagitis (GERD)

Reflux esophagitis (commonly referred to nowadays as GERD or gastroesophageal reflux disease) is the condition caused when acid from the stomach refluxes, or flows backwards up into the esophagus, or food tube. Adults call the resulting painful condition "heartburn," because it burns about at the level of the heart. Children, especially infants, have difficulty communicating about this discomfort. In infants, the symptoms generally appear during feedings or shortly thereafter, and may involve crying and pulling away from the nipple, arching the back and squirming as if in pain while feeding, or painful or quizzical expressions - the child may look as if he had something bitter or sour in his throat (which he does - it is stomach acid).

We now have a number of tools to accurately diagnose, and more importantly, medicines to effectively treat reflux esophagitis. An evaluation by a pediatric gastroenterologist or knowledgable pediatrician is definitely in order for young infants with these symptoms. See gastroesophageal reflux.

One tip: beware the blanket statement by any health care provider, "Your child cannot have reflux because he does not spit up." In my personal experience, the worst cases of painful heartburn - GERD - occur in babies who do not spit up particularly badly. It is insidious, low grade leakage of stomach acid that causes the burning pain and damage to the lining of the lower esophagus. The acid leakage need not be noticable to the parents; it often occurs in between feedings when the stomach is fairly empty (especially at night). Those babies that spit up large amounts are actually washing out the esophagus with soothing, acid neutralizing milk.

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