Acid Reflux in Teenagers

Symptoms, Diagnosis and Treatment for GERD in Teens

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young woman holding her throat from heartburn
What do you need to know about acid reflux and heartburn in teenagers?. Istockphoto.com/Stock Photo©chempju

Overview

While chronic heartburn and gastroesophageal reflux disease (GERD) are often considered to be adult disorders, they are becoming more common among children and teens. That's in part because of teenagers' fondness for fast food, as well as their ever-expanding waistlines.

As with adults, the symptoms of reflux can put a damper on life and even be frightening at times. Yet, just as with adults, simple lifestyle changes as well as medications can make these symptoms much more tolerable.

Causes

Under normal conditions, food passes through the esophagus, and the muscle at the bottom of your esophagus—the lower esophageal sphincter (LES)—closes off so food and liquids will remain in your stomach. When the LES doesn't close properly, stomach contents and acid can back up into the esophagus.

Symptoms

The following symptoms may occur if your teenager is experiencing acid reflux:

  • Burning sensation in the chest, behind the breastbone, squeezing and radiating to the back, lasting from a few minutes to hours
  • Burning sensation in the esophagus
  • Nausea
  • A sore, raw throat, especially upon waking in the mornings
  • Hoarseness
  • Bad breath
  • Trouble swallowing
  • Feeling like food is stuck in the throat
  • Feeling of choking that wakes him during the night
  • Respiratory problems (such as bronchitis, wheezing, asthma)
  • Nagging dry cough

Diagnosis

Your child's doctor may base a diagnosis of acid reflux on your child's symptoms, a physical examination and your child's response to medical treatment.

For example, if your child's symptoms improve after treating with proton pump inhibitors (PPIs), then it's probably GERD. If your child's symptoms do not improve, the doctor may order tests to determine if GERD is the cause of the reflux. These tests may include one of the following:

  • Barium x-rays: Also known as barium swallow, these are diagnostic x-rays in which barium is used to diagnose abnormalities of the digestive tract.
  • Esophageal pH monitoring: This test will measure the acidity in your child's esophagus.
  • Upper endoscopy: A tube with a camera lens and light is inserted through your child's mouth and into esophagus and stomach. The doctor may use this procedure to see if there is a narrowing (esophageal stricture) or inflammation (esophagitis) in the esophagus.

Treatment

Treating acid reflux usually works best by using a combination of approaches. You may wish to look at your child's risk factors to see if any of these can be modified. For example, being overweight increases the chance that your child will suffer from heartburn significantly. Lifestyle modifications may be enough to correct the problem for many teens, but can be a challenge at this age. Medications may be needed, and there are several categories of drugs which may provide relief.

Lifestyle Modifications

The doctor may first suggest lifestyle modifications to see if these will ease the reflux symptoms.

  • Eating smaller meals (not eating to a point of feeling "stuffed")
  • Eat more slowly
  • Avoid heartburn-triggering foods
  • Avoid eating right before bedtime, or within two to three hours of lying down
  • Prop yourself up with pillows, raise the head of your bed, or use a wedge pillow to allow gravity to help keep acid in your stomach
  • Wear clothes with loose waistbands

Medications

If reflux symptoms continue, the doctor may suggestion one of the following remedies:

  • Antacids: Antacids neutralize stomach acid. They include Tums (calcium carbonate), Rolaids (calcium carbonate), Mylanta (aluminum hydroxide and magnesium hydroxide), and Maalox (aluminum hydroxide and magnesium hydroxide).
  • Acid Suppressers: These suppress acid production in the stomach. They include Tagamet (cimetidine), Pepcid (famotidine), Zantac (ranitidine). and Axid (nizatidine).
  • Acid Blockers: These completely block acid production in the stomach. Prilosec (omeprazole), Prevacid (lansoprazole), Nexium (esomeprazole), Aciphex (raberprazole), and Protonix. (pantoprazole).

    Complications

    Complications due to chronic acid reflux are uncommon in teens, and many of these are related to long-term symptoms. Yet it's still important to be aware of these as a reminder of why treating GERD goes beyond just controlling symptoms. Complications of chronic acid reflux (that again, are rare in teens) include erosive esophagitis, Barrett's esophagus, and even esophageal cancer.

    The Bottom Line

    The teenage years can be tumultuous enough without adding acid reflux to the mix. That said, dietary practices from fast food to excess calories are increasing the incidence of the disorder in our children. Thankfully lifestyle modifications can often make a big difference, and may have other benefits as well.

    Sources:

    Putnam P. Esophagitis in Adolescents. Adolescent Medicine: State of the Art Reviews. 2016. 27(1):1-18.

    Vandenplas, Y., and B. Hauser. An Updated Review on Gastro-Esophageal Reflux in Pediatrics. Expert Review in Gastroenterology and Hepatology. 2015. 9(12):1511-21.

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