Is Acid Reflux Overtreated and Overdiagnosed In Children?

This interesting article that I saw in HealthCentral. Beth Anderson shared her views about whether acid reflux being over diagnosed in young children.

About three years ago, the comments and discussion came out in the open. Beth Anderson attended a session of the American Academy of Pediatrics where Judith Sondheimer, was updating pediatricians on the latest news in pediatric gasteroenterology. Dr. Sondheimer is a pediatric gastroenterologist in Denver and is also the editor of the Journal of Pediatric Gastroenterology and Nutrition. Dr. Sondheimer not only gave an update on reflux and several other gastrointestinal problems, she also talked at length about the over diagnosis of reflux. She was very disturbed by parents coming into her office insisting that their children need medications for reflux.

Dr. Sondheimer was also wary about public awareness campaigns educating parents about reflux in children. She was adamant that most babies who spit up are happy spitters and do not need to be treated. It seemed to be her belief that public awareness campaigns were leading parents to think that all children with even mild spitting up need treatment.

It was very interesting to hear what some gastroenterologists are thinking, but it was also disappointing that they seemed to blame the parents, the parent groups and the pharmaceutical companies. Yes, they have a few anecdotes about pushy parents, but our members have hundreds and hundreds of stories about having to fight for their child to get a diagnosis and treatment. A recent study published in the Journal of Pediatric Gastroenterology and Nutrition confirmed that parents often report a significant time delay and often have to go to several doctors.

Yes, many of our parents are frustrated. But, they are already frustrated when they call us. We strongly urge parents to work with their doctors. We urge them to be calm and we counsel them to bring charts that show how bad their child's reflux symptoms are. Many of our parents report very serious and even alarming symptoms in their children. We do not urge them to march into the doctor and demand treatment; we urge them to be good team members. We remind them that their job is to report symptoms and to be firm when they say the child has been in pain long enough. We help them learn how to be good observers and good advocates for their children.

PAGER Association has created National Tummy Ache Awareness Day to help parents learn the difference between regular tummy aches (and spitting up) and gastroesophageal reflux disease (GERD). On November 1, millions of children wake up with tummy aches from overindulging in Halloween candy. This is the perfect opportunity to talk to your child about whether their tummy feels this bad more than occasionally.

Much of our effort is spent on public awareness and education. The article in the Wall Street Journal will help children with reflux get a proper diagnosis.

If you are interested, you may want to get this book which focus on acid reflux in children:

The Reflux Book: A Parent's Guide to Gastroesophageal Reflux

Pain the chest, upper abdomen, a sign of heartburn

When there is unexplained pain in the chest or upper gastrointestinal tract, that may be a sign of an increased risk of death from alcohol-related causes, pneumonia or lung cancer.


Thus, people with these symptoms are likely to be hospitalized for "ischemic" heart disease - the type of heart disease caused by restricted blood flow in heart arteries which Dr. Estrid Muff Munk and colleagues from Aarhus University Hospital found.

The researchers noticed that when a patient with pain in the chest or the upper abdomen has normal results on a test called endoscopy, in which a scope is used to view the inside of the esophagus and the stomach, the pain may be due to undiagnosed ischemic heart disease.

To date, studies have shown that patients with this type of pain and normal upper endoscopy results have not excluded those with gastroesophageal reflux disease (GERD) or ulcers, they add. "Thus, it is uncertain whether all study subjects had truly unexplained pain."


To address this issue, researchers looked at heart disease risk and death over a 10-year period in 386 patients with pain in the chest or upper abdomen, normal upper endoscopy and no existing heart disease, and 3,793 control patients. They excluded patients with reflux, heartburn or other symptoms of GERD or ulcers.

The patients with unexplained pain were 60 percent more likely to be hospitalized over the next 10 years. They also were more than twice as likely to die within the first year of their endoscopy, while mortality risk was elevated for up to five years after the test.

Their risk of death from alcohol dependence, pneumonia or lung cancer was triple that of the general population.

Unexplained chest pain and upper abdominal pain in patients with a normal endoscopy test "is a strong marker for ischemic heart disease and increased mortality," they conclude.

[SOURCE: BMC Gastroenterology, published online July 15, 2008.]

Thus, I believe that once you start to experience the symptoms that indicate you may be having heartburn acid reflux problem, it is best to consult your doctor

Learn GERD Triggers and Avoid Heartburn

When it comes to preventative action, you need to learn GERD triggers that affect your body the most and cause your symptoms to become aggravated. There are many different theories on the cause of acid reflux – but the majority focus on the behaviors and condition of the lower esophageal sphincter (LES - a valve-like muscle which is located at the top of the stomach where the esophagus and the stomach meet).

Acid reflux tends to occur when the LES valve is functioning abnormally and allowing stomach acids, pancreatic digestive juices, bile salts, and even food to rise up into the esophagus. Such abnormal functioning can include a lower-than-normal pressure in the valve, or it may open at inappropriate times for some reason.

If you have a condition called a hiatal hernia, your sphincter may have displaced into your chest, causing it to function abnormally. When acid reflux occurs and the aforementioned substances rise up to the level of the esophageal lining; severe irritation and discomfort usually follows.

There are many different kinds of triggers that can set off these irritations and symptoms. If you experience acid reflux, you should be aware of the various common GERD triggers so that you know what to do to prevent is recurrence. Such triggers can include the following, which cause the lower esophageal sphincter to relax and therefore contribute to the worsening of its symptoms:

• Lifestyle – many different lifestyle choices can cause you to experience heartburn, so take note of the GERD unfriendly activities in your life to allow yourself the opportunity to correct them and ease your symptoms. These unfriendly activities may include drinking alcohol, smoking, being overweight or obese, and slouching or maintaining poor posture. Living a high-stress lifestyle is also among the most common contributors to aggravating acid reflux symptoms.

====>> How Diet and Lifestyle actually Cause Your Heartburn.

• Diet – many foods are known to lead to acid reflux symptoms. Foods to avoid include high-acid foods such as citrus fruits and tomatoes, spicy foods, fried and fatty foods, chocolate, caffeinated beverages, sulfuric foods such as garlic and onions, and mint flavorings.

====>> Heartburn Acid Reflux Diet: Acid Reflux Dietary Principles

• Eating Habits – beyond the food you’re eating, your eating habits can also encourage or discourage heartburn. GERD eating habit triggers include eating large infrequent meals instead of several smaller meals, sudden dietary change, and eating before lying down or sleeping instead of waiting two or three hours.

• Medications – sometimes the drugs you’re taking for other conditions can aggravate your acid reflux symptoms. Drugs known for encouraging heartburn are theophylline (Tedral, Marax, Hydrophed, Bronchial, and Quibron), calcium channel blockers, antihistamines, and nitrates.

====>>Medication Can Make Your Acid Reflux Worse

• Health Conditions – these can include many different kinds of medical, health, and body conditions, such as pregnancy, rapid weight gain, diabetes, the release of certain hormones, a hiatal hernia, or even over-exercising.

To learn, simply click here: Cure Your Heartburn