Gastroesophageal Reflux (GER)

Contents in the stomach coming back up into the esophagus. It occurs when the junction between the esophagus and the stomach is not completely developed or is abnormal. Normally, this junction prevents food from rolling out of the stomach and up into the esophagus and sometimes the mouth. GER is very common, especially among prematurely born infants. Reflux of the acid in the stomachcan irritate the lining of the esophagus and cause a form of "heartburn" in some babies with GER. Babies may feel this heartburn and become irritable and uncomfortable.

Since mild forms of GER are common, require no treatment, and go away on their own over a period of months, it is first necessary to evaluate how severe the GER is and whether or not it requires treatment.

If the GER appears to be a significant medical problem, a barium (harmless substance used to visualize the intestinal tract on X-ray) swallow or nuclear medicine scan of the stomach emptying may be performed. These tests confirm that GER is occurring and look for stomach outlet obstruction or other contributing cause. Endoscopy and pH probe studies may also be done to evaluate this GER.

Treatment of GER may include keeping the baby in the upright position,, thickening of the feedings, giving medication to reduce stomach acid, and sometimes giving medication to increase the ability of the stomach to contract. Medical treatment is effective in most cases. Since this is a problem that often improves on its own over time, surgery is reserved for the severe or unusual cases. Most children do very well in spite of GER.