Acid reflux is often thought as an adult disease, but there are many infants and children who also deal with the painful symptoms. Any child over a year old that has continued with acid reflux may also need to see a gastroenterologist. Additional testing could be warranted to rule out other causes for the symptoms like food allergies, Eosinophilic Esophagitis, Celiac disease, or even an infection.
After your older child’s reflux has been treated and is under control you may have less frequent visits with the GI. That makes it incredibly important to pay attention to your child’s symptoms and encourage them to openly communicate any new or bothersome symptoms. Some kids, like my daughter, are so used to dealing with pain that they may not tell you they are hurting until they have a more severe issue.
Here are some potential symptoms that indicate your older child needs to head back to the GI:
Your child has been on PPI medications for years
PPI medications can be wonderful to have in your arsenal of treatments for acid reflux. But more isn’t always better. New dangers and side effects of PPI medications are still being studied. If your child is on PPI medications long-term, it is important to keep regular appointments with a GI to insure the treatment is working and to monitor any potentially harmful side effects.
Puking or swallowing reflux
Puking can be an obvious sign but it is often mistaken for a stomach bug in school-age children. If the vomiting lasts more than a week you should have the pediatrician evaluate the problem. Sometimes the child will just throw up a little bit of refluxed stomach contents into their mouth and swallow it back down. If you see them gulping or they report that this is happening often (especially if it occurs when they don’t have an overly full stomach) it’s time to talk with a physician.
Increase in asthma symptoms and/or coughing
Here are some of the reasons the Asthma and Allergy Foundation of America reports that acid reflux and asthma may begin to exacerbate each other, and will continue to if left untreated:
- Asthma medications may aggravate acid reflux disease by lowering the pressure in the LES.
- Refluxed stomach contents can enter the lungs (aspiration). This further irritates the airway and increases asthma symptoms.
- Asthma’s coughing causes more acid reflux by lowering the pressure in the LES.
- Nerve reflexes that close the airway, produce mucous and cause breathing issues may be triggered by acid reflux.
Coughing can also occur without the presence of asthma due to the irritation of the throat by the acid reflux. So, whether it’s coughing or asthma, have your GI check out your child’s reflux control.
Children can develop issues swallowing due to uncontrolled acid reflux. This is because the damage to the esophagus can cause swelling of the area, making it harder to swallow. In some instances acid reflux can also lead to the narrowing of the esophagus in the form of strictures or extreme inflammation known as esophagitis. Both issues require prompt evaluation by your child’s physician.
New issues with picky eating
Picky eating can be a normal part of childhood. However, if you notice that your child is frequently turning down foods they normally love, consistently eating less at meals or flat-out refusing to eat, then it may be time to talk with a doctor. Sometimes the “picky eating” is actually the child’s way of avoiding the pain of swallowing. Be aware that certain foods, like acidic things that may burn the throat, hard foods (such as chips) or tough-to-swallow foods (like meat) may be the first to leave their food repertoire.
Chronic bad breath or tooth erosion
Dental issues can be an unintended consequence of acid reflux disease. That’s why it is really important to schedule a visit with a pediatric dentist. They may want to see your child at one year of age or after the first tooth erupts. After that, unless otherwise noted by your dentist, it is important to schedule regular appointments to have your child’s teeth cleaned – usually every six months.
Once your child’s adult teeth are in your dentist may recommend sealants. They can further protect the permanent teeth from both acid and the risk of developing cavities. Instilling good oral hygiene in your children from an early age is also key in preventing their acid reflux from doing damage to their teeth.
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Jennifer Rackley is a nutritionist and mother of three girls. Two of her children have dealt with acid reflux disease, food allergies, migraines, and asthma. She has a Bachelor of Science in dietetics from Harding University and graduate work in public health nutrition through Eastern Kentucky University. In addition to writing for HealthCentral, she does patient consults and serves on the Board of Directors for the Pediatric Adolescent Gastroesophageal Reflux Association.