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Reflux

Disclaimer: This fact sheet is for education purposes only. Please consult with your doctor or other health professional to make sure this information is right for your child.

What is reflux?

Gastro-oesophageal reflux (GOR) happens when stomach contents are brought back up into the oesophagus (throat or gullet). Reflux happens when the muscle in the lower part of the oesophagus (called the lower sphincter muscle) relaxes. All children experience reflux at some time, particularly after meals.

Some doctors consider regurgitation to be just another name for reflux. However, most doctors believe this term should be used for when patients reflux stomach contents into their mouth. Regurgitation usually stops by about 12 - 18 months of age. It occurs spontaneously and unlike vomiting is effortless.

Common symptoms of GOR disease

A small number of children with reflux develop complications including inflammation of the oesophagus called oesophagitis. Symptoms of oesophagitis can include:

• Regurgitation of blood-stained material.
• Inadequate weight gain (failure to thrive).
• Heartburn and trouble feeding.
• Tummy pain especially after meals.

GOR and colic in infants

Babies younger than three months who cry a lot and cannot be easily comforted are said to have "colic". Colicky infants who are otherwise healthy and who do not have symptoms of GOR Disease do not have colic because of reflux.

Diagnosis

Your doctor can generally tell if your child has reflux disease from your child's health history and by examining your child. If regurgitation is the only symptom of reflux, then further tests are not necessary. Special tests such as x-rays, nuclear scan, endoscopy and oesophageal pH study may be needed if your doctor thinks there might be complications from your child's reflux.

Treatment

If otherwise healthy, your child does not need any special treatment. In fact, most remedies prescribed for such infants do not work. Uncomplicated regurgitation in babies usually resolves itself by 12 - 18 months of age.

However, if your child has complications due to the reflux such as:

• vomiting so much and not gaining enough weight
• regurgitating blood
• is complaining of pain or is unsettled especially after meal times
• is choking, gagging or coughing from the reflux

some medications or a change in diet may be needed. The treatment is supervised by your doctor and/or paediatrician.

See your doctor if your baby:

• Is vomiting large amounts or also has diarrhoea.
• Is vomiting blood or bile.
• Also has blood in bowel motions or is passing black tarry stools.
• Has slow weight gain.
• Has persistent regurgitation after 18 months of age.

The Children's Hospital at Westmead Tel: (02) 9845 3585 Fax: (02) 9845 3562 www.chw.edu.au	Sydney Children's Hospital, Randwick Tel: (02) 9382 1688 Fax: (02) 9382 1451 www.sch.edu.au	Kaleidoscope, Hunter Children's Health Network Tel: (02) 4921 3670 Fax: (02) 4921 3599 www.kaleidoscope.org.au