What is esophageal reflux?

Gastroesophageal reflux (GER) is when the contents of the stomach back up into the esophagus during or after a meal. A ring of muscle called the lower esophageal sphincter (LES) at the bottom of the esophagus opens and closes to allow food to enter the stomach. With infants, when the LES opens, stomach contents often reflux into the esophagus and out the mouth, resulting in regurgitation, or spitting up, and vomiting. GER can also occur when babies cough, cry, or strain.

Symptoms:

GER is common in healthy infants. More than half of all babies experience reflux in the first 3 months of life, but most stop spitting up between the ages of 12 to 24 months. Only a small number of infants have severe symptoms. An infant with GER may

experience:

• Spitting up
• Vomitting
• Coughing
• Irritability
• Poor feeding 

In a small number of babies, GER results in symptoms that cause concern. These symptoms include:

• Poor growth due to an inability to hold down enough food
• Irritability or refusing to feed due to pain
• Blood loss from acid burning the esophagus
• Breathing problems

Diagnosis:

An infant who consistently spits up or vomits may have GER. The doctor will talk with you about your child’s symptoms and examine your child. Tests may be ordered to help determine whether your child’s symptoms are related to GER. Sometimes treatment is started without tests. If the infant is healthy, content, and growing well, often no tests or treatment are needed.

Treatment:

Treatment for GER depends on the infant’s symptoms and age and may include changes in eating and sleeping habits. Medication may also be an option. Only rarely and in severe cases is surgery (Fundoplication) required.