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Excessive weight gain in children has been linked to what were once thought to be adult health problems. those include conditions such as diabetes, heart disease, high blood pressure, and liver disease. and now recent research has added one more to the list: gastroesophageal reflux disease, also known as GERD or acid reflux.

Obese children, just like obese adults, are at an increased risk for developing this condition. in fact, studies show that obese children are at a markedly higher risk of having reflux symptoms than are normal-weight children. This higher risk exists regardless of age, race, sex, or other factors that can contribute to reflux symptoms, such as caffeine intake.

What is GERD and why is it a concern?Gastroesophageal reflux disease occurs when a valve (actually a muscle) at the lower end of the esophagus fails to stay closed. the esophagus is a tube through which food passes, going from the mouth to the stomach. Normally, this valve closes after letting food in the stomach. By closing, it keeps acid in the stomach and out of the esophagus. with GERD, though, the valve does not close tightly. This allows acid to flow back up into the esophagus.

GERD can cause symptoms ranging from mild to serious. Untreated, reflux can cause inflammation of the esophagus lining, which can lead to ulcers and scarring.

Identifying GERD in children can be tricky in the early stages. One common symptom is heartburn. Children, though, often don't know what heartburn is and may complain of a stomachache or chest discomfort. This occurs most commonly after meals.

Other symptoms or complications of GERD can include:

• Nausea
• Chronic sore throat
• Ear infections
• Persistent cough
• Asthma or wheezing

If you think your child may have GERD, it's important to get him or her to the doctor. if the condition has caused major ear, nose, or throat problems, your child's doctor may refer you to an otolaryngologist, who is an ear, nose, and throat specialist.

Tips for managing GERD in overweight childrenIf your child is overweight and has GERD, the doctor may suggest weight loss as a primary long-term goal. Weight loss will help eliminate GERD and prevent future episodes. Watching portions; limiting high-fat, high-sugar foods; increasing fruits and vegetables; and increasing physical activity will all be important for losing weight.

Also, the following strategies can help reduce or relieve the immediate symptoms of GERD.

Identify problem foods. Certain foods are known to have a higher risk of causing symptoms. but every child is different, and some foods may bother some kids but not others. Pay close attention to what your child eats and be especially careful with the following:

• Sodas that contain caffeine
• Chocolate
• Peppermint
• Spicy foods
• Acidic foods like oranges, tomatoes, and pizza
• Fried and fatty foods

Eat small, frequent meals. Smaller meals are less likely to produce reflux symptoms.

Avoid eating close to bedtime. Late-night eating can make symptoms worse once your child goes to bed. There should be at least a three-hour window between dinner or evening snack and bedtime.

Try sugarless gum. Several studies have shown that chewing sugarless gum after a meal can help reduce reflux symptoms.

Elevate your child's head while sleeping. Raising the head of your child's bed about 30 degrees can help reduce symptoms at night. Placing pillows under the actual mattress is more effective than just using pillows under your child's head.

Will your child need medical treatment?Your child's doctor will recommend treatment based on your child's symptoms. most of the medications prescribed for GERD either break down or lessen intestinal gas or decrease or neutralize stomach acid. Surgery is rarely required to treat GERD in children.

SOURCES:

• Flynn MAT, McNeil DA, Maloff B, et al. Reducing obesity and related chronic disease risk in children and youth: a synthesis of evidence with 'best practice' recommendations. Obesity Reviews. 2006;7(Suppl 1):7-66.
• Pashankar DS, Corbin Z, Shah SK, Caprio S. Increased prevalence of gastroesophageal reflux symptoms in obese children evaluated in an academic medical center. Journal of Clinical Gastroenterology. 2009;43(5):410-413.
• National Digestive Diseases International Clearinghouse. Heartburn, gastroesophageal reflux (GER), and gastroesophageal reflux disease (GERD). Accessed: 09/21/2010
• Pediatric gastroesophageal reflux clinical practice guidelines: joint recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) Journal of Pediatric Gastroenterology and Nutrition. 2009;49(4):498-547.
• American Academy of Otolaryngology. Fact sheet: pediatric GERD. Accessed: 09/21/2010

View the original the link between childhood obesity and GERD article on myOptumHealth.com