Pediatrics - GERD Treatment
The goals of GERD treatment are to reduce reflux, relieve symptoms, and prevent damage to the esophagus. Some doctors recommend treating GERD in a step-wise fashion. For cases of mild GERD, lifestyle changes may be enough. The second step is to use nonprescription antacids. More severe cases may need prescription medication or surgery. Surgery is never the first treatment option for GERD.
Simple lifestyle changes may help relieve the symptoms of mild GERD. These include not smoking, not drinking alcohol, and not consuming foods that irritate the esophagus. It is helpful to eat small meals throughout the day instead of large meals. Your child should avoid eating before bedtime or lying down after eating. It can be helpful to raise the head of your child’s bed six inches. Additionally, your child should maintain a healthy weight and good posture.
If lifestyle changes do not work, it can be helpful to use an over-the-counter antacid. Antacids work by neutralizing the stomach acid and coating the stomach. Antacids relieve symptoms rapidly, but only temporarily. If your child needs antacids for over two weeks, you should contact your doctor and discuss other appropriate treatments.
Your doctor may prescribe a stronger medication, usually acid blockers or histamine-2 (H2) blockers. These drugs block acid creation in the stomach. They prevent GERD because there is less acid to back up into the esophagus. If the acid blockers fail, your doctor may prescribe medications that are proton pump inhibitors. Proton pump inhibitors stop all acid production in the stomach. Another medication option is promotility drugs. Promotility drugs speed up the rate that the stomach empties food and acid. They also help to tighten the LES. This helps to prevent stomach acid from backing up into the esophagus.
Your child may need surgery if prescription medications fail and your child is experiencing serious complications. The operation for GERD is called a fundoplication. It involves tightening the LES and tying the stomach to prevent stomach acid from entering the esophagus. Fundoplication surgery is successful for most people.
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