Holidays Present Challenges for Children With GERD

BRAINTREE, Mass. -- It seems to begin earlier each year -- freshly picked apples covered in chocolate and caramel fill the aisles in markets all over the country before we've even bid farewell to summer sun. Halloween brings the endless variety of candy awaiting excited trick-or-treaters. The veritable food fest between Thanksgiving and New Year's Day brings tantalizing and tasty delights for all. However, for the large number of U.S. children with acid reflux or gastroesophageal reflux disease (GERD), holiday dining isn't always a happy occasion.

"Avoiding certain foods is key to the management of pediatric GERD. Unfortunately, for most children with the condition, the holidays are an especially trying time, because their families' rich holiday foods become off-limits," said Carlo DiLorenzo, MD, Chief, pediatric gastroenterology, Columbus University Children's Hospital and Ohio State University School of Medicine. "Parents can make holiday dining easier for their children by preparing alternate dishes that don't include chocolate or acidic foods like tomatoes and by making sure children take any medications that were prescribed for their condition."

Other helpful tips for managing the symptoms of GERD during the holidays:
-- Take breaks between the courses of holiday dinners. Eating smaller, more frequent meals can aid digestion and prevent some of the symptoms of GERD.

-- Ensure that children do not eat meals or treats too close to bedtime.

-- Avoid foods such as carbonated drinks, chocolate, caffeine, and those that contain a lot of acid (citrus, pickles, tomato products) or spicy foods.

-- Avoid exposing children to tobacco smoke.

-- Work with the child's doctor to determine if he or she may benefit from medications to treat GERD. One group of medications that aims to decrease the amount of acid the stomach produces is called H2-blockers. Examples include nizatidine (Axid® OS), ranitidine, famotidine and cimetidine.

-- Find a treatment that is easy for the child to take -- large pills or harsh-tasting medications will only make a difficult situation worse. An effective H2-blocker like Axid® Oral Solution is more kid-friendly in its bubble gum flavored formulation.

"The goal of managing a child with GERD is to reduce the amount of stomach acid and contents that 'back up' into the esophagus. The reflux can damage the esophagus, so we try to help parents prevent and reduce GERD symptoms and promote healing through lifestyle changes, but if that doesn't work, medications that reduce the production of stomach acid are also helpful options," DiLorenzo explained.

Almost all children have gastroesophageal reflux as infants, when the stomach contents back up, and such "burping up" after feeding is normal. Reflux usually improves gradually until age one or two years, when a child starts eating solid foods and eats upright on his or her own. However, almost all children and adults have a little bit of reflux, without being aware of it. But if more substantial reflux occurs, the related symptoms or complications are called GERD.

GERD occurs when the muscular ring that closes off the bottom of the esophagus from the stomach briefly relaxes and then opens during or after a meal. The open "doorway" from the stomach allows food and acid to return to the esophagus and, in some cases, the mouth. When refluxed material rapidly returns to the stomach, no damage occurs to the esophagus. But when the stomach contents remain, it can damage the lining of the esophagus. If the esophageal inflammation is untreated, scarring or ulcers may form. Chronic inflammation also can result in changes to the lining of the esophagus known as Barrett's mucosa, which has the potential to increase the risk of esophageal cancer.

While antacids neutralize stomach acid and are available as non-prescription medications, acid suppressants are medications that decrease the stomach's acid production. One type of acid suppressant is recommended as a first-line therapy for pediatric GERD: the histamine-2 blocker. This medicine blocks a receptor on a special type of cell in the lining of the stomach that normally helps turn on acid production. Because H2-blockers do not completely turn off acid production, enough acid remains to help a child digest food.

Source: Braintree Laboratories

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