What is gastroesophageal reflux disease?

Gastroesophageal reflux disease (GERD) is a digestive disorder where the muscle at the end of the esophagus doesn’t close properly, allowing stomach contents to move back up into the esophagus. It is also called heartburn or acid reflux.


The symptoms of GERD in children can vary. They may include:

  • heartburn, which is a burning or pain in the mid-chest
  • spitting up or vomiting
  • problems swallowing
  • bad breath
  • nausea
  • fussiness at mealtimes
  • gagging or choking
  • coughing at night
  • poor weight gain


Your child may need one or more of these procedures to diagnose GERD:

  • high-resolution esophageal manometry: measures the pressure in the esophagus
  • endoscopy: uses a thin, lighted tube to “see” inside the esophagus
  • pH impedance testing: measures the amounts of acid in the child’s esophagus
  • upper GI (gastrointestinal) endoscopy: uses a flexible tube placed from the mouth into the stomach to see inside the child’s upper GI tract
  • upper GI (gastrointestinal) series: examines the organs of the upper part of the digestive system using barium, a liquid that coats the inside of organs so they will show up on an x-ray
  • gastric emptying studies: determines if the stomach contents empty into the small intestine properly


GERD treatment varies with the age of the child. Infants may need no other treatment beyond different ways of positioning and feeding.

Other children may need to take medications to reduce stomach acid, or make the stomach empty faster. Lifestyle and dietary changes may also help.

In some cases, children with severe GERD may need surgery.

Learn more about Pediatric Gastroenterology services at Boston Children’s Health Physicians.

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