GERD symptoms in children: Watch out for sour breath, chronic cough, nausea and other signs of discomfort

GERD can significantly impact a child's quality of life, but with proper diagnosis and management, we can help them live comfortably (Image: Canva)

When you notice your child frequently complaining of a burning sensation in their throat or perhaps refusing to eat certain foods because they’re worried about pain, it might be time to consider gastroesophageal reflux disease (GERD). Symptoms like sour breath or even the sensation of food getting stuck in their throat can indicate a deeper issue.

"GERD can significantly impact a child's quality of life, but with proper diagnosis and management, we can help them live comfortably,” says Dr Ronak Tate, Consultant Gastroenterology at Fortis Hiranandani Hospital Vashi. Gastroesophageal reflux (GER), he explains, occurs when the acidic content of the stomach flows backward (retrograde) into the esophagus, mouth, and sometimes the lungs. “This happens when the lower esophageal sphincter, a valve-like muscle at the end of the esophagus that prevents this backward flow, is not functioning properly. When GER becomes long-term and severe, it is referred to as gastroesophageal reflux disease (GERD),” Dr Tate adds.

After food is swallowed, it travels from the mouth through the esophagus (food pipe) to the stomach, where it mixes with the acid present in the stomach. “A ring of muscles in the esophagus, called the lower esophageal sphincter, prevents stomach acid from flowing back into the esophagus. When this muscle is underdeveloped, as it is in infants, or malfunctions, reflux occurs,” says Dr Tate.

Also read | Heartburn, chest pain and cough? Try these home remedies for gastroesophageal reflux disease

He suggests one should watch out for the following symptoms of GERD: 

Symptoms of GERD can vary based on the severity and duration of the disease, as well as the child’s age. Here are a few symptoms to watch out for:

• Oral symptoms may include bad breath (halitosis), which happens due to acid exposure affecting oral bacteria, a bad taste in the mouth from acid reflux, tooth erosion resulting from acid damaging tooth enamel, throat pain caused by irritation, and spitting (not vomiting), which is often confused with vomiting but is usually less forceful and does not contain bile.

• Feeding-related symptoms: These often involve refusal to eat due to discomfort, difficulty swallowing (dysphagia), choking or gagging when eating, and eating small portions or avoiding certain foods, which can lead to nutritional deficiencies and inadequate caloric intake.

• Upper digestive symptoms: They can manifest as a burning sensation or pain in the upper abdomen (heartburn), nausea from stomach acid irritating the lining of the esophagus, and vomiting, which may be forceful or contain blood, indicating possible esophageal injury or bleeding.

• Respiratory symptoms: These symptoms may present as a chronic cough that often worsens at night, potentially due to aspiration of acid into the lungs, wheezing that may mimic asthma as acid irritates the airways, chest pain that can be mistaken for heart-related issues, and hoarseness due to laryngitis resulting from acid exposure to the vocal cords.

• Other Symptoms: They can include irritability due to hunger, pain, or dehydration, arching of the back (common in infants), which is a response to discomfort, poor weight gain due to feeding difficulties, and dehydration from insufficient fluid intake or vomiting.

Managing GERD in children involves a combination of medical and surgical interventions. “Parents and caregivers should focus on maintaining proper posture, such as sleeping with the head elevated and keeping the child in an upright position after meals, while avoiding lying down for 2-3 hours after eating,” says Dr Tate, adding, “Treating constipation is also essential, as it can exacerbate GERD symptoms. Additionally, addressing contributing factors like obesity and avoiding certain trigger foods, including spicy or fatty items and mint candies, as well as minimising exposure to passive smoking, can significantly improve the child’s condition.”

Disclaimer: This article, including health and fitness advice, only provides generic information. Don’t treat it as a substitute for qualified medical opinion. Always consult a specialist for specific health diagnosis.