This is part 2 of a 3-part series on Acid Reflux.See Part I: Your Baby and Acid Reflux
Going to School
My daughter's gastroenterologist used to write a note on the prescription pad for school each year. It said simply, "Rebecca needs to have access to snacks, drinks and the bathroom as needed during school to manage her GERD."
I met with her new teacher and the school nurse each fall to develop a plan for managing acid reflux at school for the year. Rebecca was able to attend school, manage her acid reflux and concentrate on learning rather than a painful stomachache.
Kids and teens may face special challenges managing GERD at school. There are long lines in the cafeteria and little time to eat. Eating with 300 teenagers is hardly the atmosphere to chew slowly and carefully. Limited access to the bathroom and the nurse for medication may get in the way of the treatment plan as well. Parents may need to meet with the school administration and the nurse to develop a plan to manage GERD at school. In addition, your child's doctor or gastroenterologist may need to write a note outlining the treatment plan.
Gastroesophageal Reflux (GER) is a normal event characterized by the sensation of food coming up the esophagus in the form of a wet burp. Many children and teens have GER after eating a large meal, drinking a carbonated beverage or eating too fast.
GER symptoms may include:
o Sensation of food coming up the throat
o Bad taste in the mouth
On the other hand, Gastroesophageal Reflux Disease (GERD) is the abnormal backwashing of stomach contents and acid into the esophagus causing complications. GERD may cause esophagitis (irritation to the delicate lining of the esophagus), ulcers and respiratory issues.
GERD symptoms may include the symptoms of GER plus:
o Picky eating
o Weight loss
o Poor sleep
For some children, GERD symptoms began in infancy and continued into childhood. Other children seem to have healthy digestion in infancy and develop GERD during childhood or adolescence. Parents and doctors may not initially suspect GERD in an otherwise healthy child.
o Wear loose, comfortable clothing
o Avoid tobacco smoke
o Avoid physical activity after a meal
o Sleep on an elevated surface (extra pillows, wedge, bed blocks)
o Reduce stress
Children and teens may need to limit or avoid:
o Caffeine-cola, coffee, tea, iced tea
o Energy drinks such as Red Bull and Rock Star
o Citrus (oranges, orange juice)
o Tomatoes and tomato sauce
o Carbonated drinks-soda, seltzer
o Spicy food
o High fat foods and fried foods
Children and teens may need to:
o Eat small, frequent meals.
o Avoid eating before bedtime.
o Eat slowly and chew well.
Over the counter or prescription medication may be needed to reduce or eliminate acid or improve motility. (Note: Only give your child or teen medication recommended by the doctor. While it is tempting to try to treat the reflux yourself with the selection of over the counter medications in the local drug store, your doctor should be consulted for the proper medication and dose for age and weight.)
Following the doctors treatment plan may be challenging for children and parents. Older children and teens may resist rules on healthy eating and limited diets. Some children do not like to take medication or stop taking medication when they feel better. It is hard for children and teens to understand that medication and a special diet can stop the symptoms as well as prevent the symptoms from coming back.
Long Term Outlook
Children and teens with GERD respond readily to treatment and can participate in school, sports and social activities. While GERD may not go away, it can be managed. Children and teens with GER need to watch their diets, maintain a healthy lifestyle, and take medication as directed to reduce symptoms. If the symptoms worsen or become more frequent, it is time to see the doctor, who can adjust treatment as the children grow to prevent complications.
Published On: January 11, 2008