What is reflux?
Gastro-oesophageal reflux (GOR) happens when stomach contents are brought back up into the oesophagus (throat or gullet). Reflux happens when the muscle in the lower part of the oesophagus (called the lower oesophageal sphincter) relaxes. All children experience reflux at some time, particularly after meals.
Some doctors consider regurgitation to be just another name for reflux. However, most doctors believe this term should be used for when patients reflux stomach contents into their mouth. Regurgitation usually stops by about 12 - 18 months of age. It occurs spontaneously and unlike vomiting is effortless.
Common symptoms of GOR Disease
A small number of children with reflux develop complications including inflammation of the oesophagus called oesophagitis. Symptoms of oesophagitis can include:
- Vomiting or regurgitation of blood-stained or coffee ground material.
- Inadequate weight gain (failure to thrive) due to vomiting and/or poor feeding.
- Feeding difficulties especially in younger children and infants.
- Irritability and unsettled behaviour during or after feeds in infants.
- Heartburn in older children.
- Tummy pain especially after meals in older children.
- Passing black tarry stool.
GOR and colic in infants
Babies younger than three months who cry a lot and cannot be easily comforted are said to have "colic". Colicky infants are otherwise healthy infants who are thriving (gaining weight) and who do not have symptoms of reflux. A small number of babies have non-specific irritability related to reflux. Generally, however, reflux does not cause colic.
Your doctor can generally tell if your child has reflux disease from your child's health history and by examining your child. If regurgitation or vomiting is the only symptom of reflux, then further tests are not necessary. Special tests such as x-rays (Barium Meal), nuclear scan, endoscopy and oesophageal pH study may be needed if your doctor thinks there might be complications from your child's reflux.
If otherwise healthy, your child does not need any special treatment. In fact, most remedies prescribed for such infants do not work. Uncomplicated regurgitation in babies usually resolves itself by 12 - 18 months of age.
However, if your child has complications due to the reflux such as:
- excessive vomiting and not gaining enough weight;
- vomiting blood;
- is complaining of pain or is unsettled especially after meal times;
- is choking, gagging or coughing from the reflux,
some medications or a change in diet may be needed. The treatment is supervised by your doctor and/or paediatrician.
See your doctor if your baby:
- Is vomiting large amounts or also has diarrhoea.
- Is vomiting blood or bile.
- Also has blood in bowel motions or is passing black tarry stools.
- Has slow weight gain.
- Has persistent regurgitation after 18 months of age.