Table of Contents
- Changes in diet can include eliminating foods that are acidic or possibly associated with reflux, such as tomatoes, chocolate, mint, juices, and carbonated or caffeinated drinks.
- Obese children should try to lose weight.
- Milder medications, such as antacids, are used first. However, long-term use of these drugs is generally not recommended due to side effects such as diarrhea or constipation.
- PPIs may also be effective in children. A delayed-release capsule and liquid form of Nexium has been approved for the short-term (up to 8 weeks) treatment of GERD in children ages 1 - 11. Nexium capsules were previously approved for use in children ages 12 - 17, also for short-term GERD treatment. The PPI rabeprazole sodium (ACIPHEX) is approved for the short-term (up to 8 weeks) treatment of adolescents ages 12 and over. PPIs appear to be safe and effective even for children as young as 1 year old who fail the less intensive therapies. However, children treated with H2 blockers and PPIs may have an increased risk of developing respiratory and intestinal infections.
- H2 blockers are available over the counter and include famotidine (Pepcid AC), cimetidine (Tagamet HB), ranitidine (Zantac 75), and nizatidine (Axid AR). Note: The FDA has issued a warning on Pepcid AC for people with kidney problems – see below in the Medications section.
Surgical fundoplication involves wrapping the upper curve of the stomach (fundus) around the esophagus. The goal of this surgical technique is to strengthen the LES. Until recently, surgery was the primary treatment for children with severe complications from GERD because older drug therapies had severe side effects, were ineffective, or had not been designed for children. However, with the introduction of PPIs, some children may be able to avoid surgery.
Surgical fundoplication can be performed laparoscopically through small incisions. Weakening of the LES over the long-term occurs with children as well as adults.
Review Date: 07/11/2010
Reviewed By: Reviewed by: Harvey Simon, MD, Editor-in-Chief, Associate Professor
of Medicine, Harvard Medical School; Physician, Massachusetts
General Hospital. Also reviewed by David Zieve, MD, MHA, Medical
Director, A.D.A.M., Inc.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)
