GERD in children Middle East

Some may think that esophageal reflux is an unusual symptom in both children and adults, but the fact that reflux in children, especially the youngest, is a familiar symptom, but of course disturbing, a source of pain and suffering. discomfort.
The word "reflux" refers to the return of acidic acid (hydrochloric acid) in the stomach to the esophagus, especially if there is something similar to the valve in the the lower part of the esophagus when it is connected to the stomach (the opening of the heart) prevents the arrival of this fluid in the esophagus, which makes it gives a sense of acute pain. The general expression of this pain is heartburn, a deep and real expression of pain, because acids are usually considered caustic substances, and the effect of hydrochloric acid is so powerful that it can dissolve the metals. Of course, these acids are essential for digestion of food by the stomach.

Causes and symptoms
The valve located at the end of the esophagus and at the beginning of the stomach regulates digestion so that the muscles of the hole loosen during swallowing, thus allowing food to move from the esophagus to l & # 39; stomach. After the passage, these muscles contract again, which prevents the arrival or the return of the liquid.
Such a reaction has several reasons:
> Genetic factor (although there is no clear explanation).
> Obesity, which plays an important role in increasing the risk of reflux due to increased pressure on the abdomen.
> In infants and young children, there may be delays in the growth of the valve-developed muscles that help them function.
> Birth of a child with a congenital anomaly such as cerebral palsy that can lead to neurological dysfunction of the muscles.
> If the child is constantly exposed to second-hand smoke.
Some medications can cause an increase in acidity and back pain, such as sedatives, which many mothers may use for various pains.
The symptoms of reflux vary considerably in children and their severity varies with age. Young children experience mild symptoms, such as the taste of food in the mouth or tingling in the throat, while older children may feel the burning sensation in the middle of the chest and that the smell of breath does not occur. Is not desirable. Sometimes the pain is severe and causes crying. Snoring can occur. In acute cases where stomach ulcers may appear in the stool or in the child's diaper, he / she suffers from discomfort and anxiety. After having fed him as a result of a pain.

Diagnosis and treatment
The diagnosis of relapse depends mainly on the symptomatic and pathological history described by the mother. If there is no improvement after the change in the quality of food and antacid treatment, the doctor resorts to several tests such as:
> Radiation on the esophagus in which the child drinks a certain substance The term barium (barium) refers to the esophagus from the inside. In young children, this dye is mixed with artificial milk.
> Measure the acidity of the stomach and see if it increases or not.
If improvement is not possible, the doctor may perform a toposcopy at the end of the gastrointestinal tract and take a sample. It is the most accurate diagnosis whose cause can be clearly identified if the lining of the stomach and esophagus is weakened.
The treatment includes:
> Change the lifestyle and change the style of food. These are two factors that determine how to treat reflux in children, including loosening foods and beverages containing acids such as orange or lemon juices, as well as foods containing burning spices. Meals should also be saturated with fat and small. Weight loss should be attempted in obese children. After eating, it is recommended that the child be in the current situation, ie that he / she does not fall asleep immediately after eating. Preferably, the child sleeps so that his head is elevated so that sleep does not help to bring acid back into the esophagus.
Drugs If they do not improve after the change in food quality and lifestyle, it is often used drugs equivalent to acid antacids from the stomach, used for a short time and leading to immediate improvement of symptoms These drugs do not affect the frequency of reflux episodes and acidity, but relieve pain. It is also sometimes used to confirm the diagnosis because it immediately improves the symptoms, but these drugs should not be used for a prolonged period in children.
In the case of continuous improvement, drugs that reduce gastric acid secretion may be used. These drugs should also be used for a short time, as recommended by the American Academy of Pediatrics, as they have adverse effects on bone health.
The last solution in children is pharmacotherapy. The mother should be patient because symptoms improve within 6 months of using special precautions and lifestyle changes. Mothers should avoid taking any medication except for medical reasons, as described by The doctor does not even expose the child to a risk of relapse.
– Consultant in Pediatrics