Heartburn refers to a digestive problem, where the acid in stomach comes into contact with the lining of esophagus. Normally the valve at the junction of esophagus and stomach prevents the backward flow of stomach contents, but at times it fails to do so allowing a reflux of acid into esophagus. That is why; it is also referred to as acid reflux or gastro-esophageal reflux. Most of the people feel it occasionally after a meal. However, it is not a disease that is restricted to adults. Children and even infants are known to suffer from it.
Treatment depends on the condition and age of the children. Different classes of medications are used for different purposes. H2 blockers like Ranitidine and Cimetidine are used to prevent the reflux of acid into the esophagus. They are usually in liquid form. That makes their acceptance by children relatively easier. Proton-pump inhibitors (PPI) like Esomeprazole and Omeprazole block the production of hydrochloric acid in stomach. Their side effects may appear in the form of constipation, nausea, and headache. Prokinetic agents like Metoclopramide and Erythromycin strengthen the valve present at the junction of esophagus and stomach a.k.a. LES (Lower Esophageal Sphincter). Combined with antacids, these medicines inhibit the reflux of acid into the esophagus. They are known to have some serious side effects like anxiety, diarrhea, and nausea. They may also adversely react to other medicines and hence it is advisable to inform the doctor about any other medicine that is administered to the child.
There are a number of medicines for heartburn in the market but none of them actually cures it. Medicines work on the symptoms of the disease and try to alleviate it. They are known to have serious side effects like weakening the digestive system. So it is advisable to take any medicine only after consulting your doctor. Since heartburn may be a symptom of certain more serious diseases like hiatus hernia, ulcer or even cancer, it is well worth the effort to consult the doctor in chronic cases. In extreme cases, surgery may be the last option. Children seldom reach such stage but it becomes the last resort if they do not respond to medication for a long time. Alternative medicines are also available.
There are a number of medicines in Homeopathy that work on heartburn. Similarly, Ayurveda offers a number of herbal medications that can cure it. All these medicines are largely without any side effect but they should not be treated like over the counter drug. It is good to consult a qualified doctor of these alternative systems of medicine before taking any drug. Homemade remedies may be tried for sometime but if the condition is not improving then it is always better to consult a doctor.
Several factors may contribute to the occurrence of heartburn in older children: –
Incomplete closing of the Lower Esophageal Sphincter, the a valve that prevents reverse peristalsis i.e. the backward flow of the contents of stomach into esophagus. Consumption of acidic, spicy, fatty, fried food, chocolates, peppermint, etc. Acid reflux may make the esophagus sensitive to citrus fruits, garlic, onion, tomato, etc. Eating such food will worsen the situation. Stress aggravates heartburn by increasing the flow of acid in stomach. It also makes the process of transition of food from the stomach to duodenum slower causing the food to stay in the stomach for a longer period of time increases the chances of acid reflux. Some medicines like aspirin also give heartburn as side-effectHiatus hernia also facilitates acid reflux causing heartburn.
Mild heartburn may occur once a month, while severe heartburn may occur every day. It can also cause problems in swallowing and even weight loss. It may be an indication of more serious problems like hiatus hernia, gastroesophageal reflux disease (GERD), inflammation of the esophagus, or even cancer. So it is not advisable to ignore persistent heartburn in children. If it is too frequent and chronic, then consulting a doctor would be a good idea.
Symptoms of heartburn in children
In newly born babies, spitting up after feeding is a common symptom of reflux of stomach content into the esophagus and mouth. Unlike vomiting, it is not forceful and hardly causes any discomfort in the infant. By the end of one year this symptom subsides as the muscles of esophagus and stomach develop better coordination. In some cases, the reflux may continue, and then it acquires the potential to create problems later in life. Vomiting after eating is a common symptom in such children. They may become irritable. They may arch their back and cry. Irritations in the esophagus, abdominal pain above the navel, and/or chest pain are other common symptoms of the more serious reflux disease called GERD (Gastro-Esophageal reflux Disease).
Symptoms may also manifest themselves as reduced appetite, weight-loss, gagging, and choking. Children become too picky about the food and eat only a few morsels despite hunger. They may also suffer from bad breath, runny nose, bronchitis, sore throat, hoarse voice, or even asthma. Frequently waking up in night, tooth decay, sinusitis, ear infections, drooling and salivation may also indicate reflux disease. Feeling sourness in the mouth may also indicate it if it is frequently felt after feeding. Such infants or children feel better if they are kept upright. They do not like to let their stomach touched by anything because the pressure aggravates their situation.
Symptoms of heartburn resemble symptoms of many other diseases. So it is better to consult a doctor for a proper diagnosis. A doctor will conduct some tests and identify the problem and its causes. Self-medication is not advisable as most of the medicines alleviate the symptoms only and don’t cure the disease itself. Almost all medicines have their own side effects, which may be serious. Some medications may not gel with a particular medication and aggravate the situation. So it is advisable to take any medication only after consulting a doctor. However, some homemade remedies may be taken for sometime to see if they have any good effect or not. Apples, papaya, carrot, potato juice, etc. help to control the disease.