Infants and Acid Reflux

Infant acid reflux is quite common. People of all ages, especially infants because they consume only liquids or soft foods, suffer from mild heartburn or acidic regurgitation on occasion. As in adult cases, infants experience acid reflux when the lower esophageal sphincter (LES) is relaxed. The LES acts as a valve between the esophagus and the stomach. It opens up to allow food into the stomach and then closes in order to protect the esophagus and other organs from acidic reflux. Unfortunately, it is difficult to determine if an infant has developed a chronic form of heartburn called gastroesophageal reflux disease or GERD.

In order to determine if an infant has a chronic form of heartburn (GERD) you should consult your pediatrician. Look for clues such as sleeping problems, coughing, weight loss, lack of appetite, spitting up frequently, and apnea. Acid reflux disease can cause respiratory problems including pneumonia, strictures and ulcerations on the esophageal wall, and malnourishment. Infant acid reflux symptoms usually include recurrent coughing, bad breath, spitting up frequently, unusual irritability and crying, chest pain, and sore throat.

There are several causes of acid reflux in infants. Many of the causes are exacerbated by the fact that infants, much more so than adults, consume mostly liquids and spend a great deal of time on their backs or in a supine position. Combined with the backwash potential of liquids, lying down puts pressure on the LES (esophagus valve) and increases the chances for reflux. Other causes could be attributed to the anatomy of a childs stomach position, poor eating habits, smoking (second hand), being overweight, and food allergies.

In addition to GERD, infants can be diagnosed with a functional version of acid reflux. This condition can be improved with simple modifications such as changing eating habits, keeping the child upright after eating, and encouragement. GERD, or the chronic disease, requires medical treatment by a physician, prescription drug therapy, as well as lifestyle changes.

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Complications Arising From Acid Reflux

Acid Reflux or Gastroesophageal reflux disease (GERD) is a condition in which the liquid content of the stomach backs up or refluxes into the esophagus. The liquid can inflame and damage the lining of the esophagus. This regurgitated liquid mainly contains acid and pepsin, both being produced by the stomach. It may also contain bile. Amongst all the contents of the liquid, acid is the most harmful.

Once GERD starts, it stays for life-long. GERD is a chronic condition and the treatment has to continue indefinitely. The reflux of the stomachs liquid contents into the esophagus occurs in normal individuals also. The difference of it occurring in GERD patients is that the refluxed liquid contains more acid that often remains in the esophagus for longer duration. The body has ways of protecting itself from the effects of reflux and acid. Saliva contains bicarbonate that neutralizes the small amount of acid that remains in the esophagus. Gravity, swallowing and saliva are the protective mechanisms for the esophagus when an individual is in the upright position.

There are various complications arising because of acid reflux.

Ulcers

The cells lining the esophagus are sometimes damaged due to the reflux of liquid from the stomach into the esophagus. An ulcer is a break in the lining of the esophagus that occurs in an area of inflammation. It may give rise to bleeding in the esophagus. When the bleeding becomes severe, blood transfusion is required along with endoscopic or surgical treatment.

Strictures

Scars are formed when the ulcers of the esophagus heal. The scar tissue shrinks and narrows the lumen of the esophagus. This scarred narrowing is called a stricture. It may cause swallowed food to get stuck in the esophagus. Barretts esophagus Severe GERD or Long-standing cause cells to change that line the esophagus. These cells then become pre-cancerous and then finally cancerous.

Cough and Asthma

Some nerves in the esophagus are stimulated by the refluxed acid, which results in pain. Other nerves that are also stimulated provoke coughing. The stimulated esophageal nerves that connect to the nerves going to the lungs causes the breathing tubes to narrow, resulting in an attack of asthma.

Inflammation of the throat and larynx

When the refluxed liquid gets past the upper esophageal sphincter, it enters the throat and the voice box, causing inflammation and soar throat.

Inflammation and infection of the lungs

The reflux of liquid into the lungs results in coughing and choking. This can lead to infection of the lungs and result in pneumonia.

Fluid in the sinuses and middle ear

Found in children, it is caused when the sinuses and middle ears are closed off from the nasal passages by the swelling of the adenoids. Fluid is then accumulated within them.

GERD is treated with life-style changes, antacids, histamine antagonists (H2 blockers), proton pump inhibitors (PPIs), pro-motility drugs, foam barriers, surgery, and endoscopy.

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