GER (Gastroesophageal Reflux) Patient Information

What is Reflux?

Reflux occurs when stomach contents back up into the esophagus (the tube that connects the mouth to the stomach). Many normal infants have some spitting up or reflux without any risk to their health. Sometimes the esophagus can become raw and irritated by the stomach contents. When the stomach contents back up into the esophagus they may be vomited and aspirated (breathed) into the lungs. When your child has trouble breathing, he/she may become red in the face or even have blue color around the lips. You may also be able to hear and feel "rattling" in the chest and back.

Structures effected by reflux

Signs of Reflux:

  • Belching
  • Tummy aches
  • Frequent vomiting
  • Frequent cough
  • Coughing fits at night
  • Hiccups
  • Heartburn in older children
  • Wheezing
  • Refusal to eat
  • Chest pain
  • Fussiness around mealtimes
  • Frequent upper respiratory infections (colds)
  • Frequent sore throats in AM
  • Gagging
  • Choking

Testing for Reflux:

If the doctor feels that your child has significant reflux, he/she may refer your child for a special x-ray called an Upper GI (UGI). A white liquid called barium will be given to your child to drink. Your child will be on a table while x-ray pictures are taken with a large camera that hangs down from the ceiling. The camera will not touch or hurt your child. The pictures will show how barium flows through the esophagus, stomach and first part of the small intestines. Your doctor will explain the results of the test to you.

A Gastric Emptying Scan is sometimes ordered to look at how fast the stomach empties a feeding. This test can also show reflux episodes and rarely aspiration (when food is refluxed up into the lungs).

A pH probe is also a test that is done to see if your child has significant reflux or if the reflux is causing systems such as ‘blue spells’ or coughing. A small tube is placed into your child's esophagus through his nose. If necessary, a wireless probe may be placed during endoscopy. A machine records the amount of acid in your child's esophagus and the doctor can learn how often your child refluxes.

Home Care:

There are a few things you should do after your child goes home to make him/her feel better. These things will also decrease your child's chance of vomiting.

For Infants:

  • Play with, bathe, and/or change diapers before feeding.
  • Feed smaller amounts but feed more often.
  • Feed slowly, holding your baby upright.
  • Burp your baby after he/she takes 1 to 2 ounces of formula.
  • For breastfed infants, burp after feeding on each side.
  • Handle your baby gently after the feeding.
  • Hold your infant upright in your arms for 30 minutes after feeding when possible.
  • Infants with GER should usually sleep on their backs, as should all infants. Your doctor may also suggest other positions.
  • Give medicine as ordered.
  • The doctor may instruct you to thicken feedings with rice cereal (1-2 tablespoons for 4 oz) or use special formulas that are pre-thickened.
When to Call Your Child's Doctor:
  • Your child's vomiting seems worse or occurs more often
  • The vomited fluid is green or yellow or looks like coffee grounds or blood
  • The medicine is vomited two days in a row
  • Your infant becomes very fussy
  • Your child complains of pain
  • Your child has problems breathing during or after feedings
  • Your child has trouble swallowing or complains of pain when swallowing
  • You notice choking spells
  • Your child will not take feedings
  • If you have any questions or concerns