Gastroesophageal Reflux Disease (GERD) in Infants or Children
Drugs to Lessen Gas in Babies and Children
Drugs to lessen gas include:
- Simethicone such as Mylicon
Drugs to Neutralize or Decrease Stomach Acid
Drugs to decrease stomach acid include:
- Antacids such as Mylanta and Maalox
- Histamine-2 (H2) blockers such as Axid, Pepcid, Tagamet, or Zantac
- Proton-pump inhibitors such as Nexium, Prilosec, Prevacid, Aciphex, Zegerid, and Protonix
Researchers aren't sure whether decreasing stomach acid lessens reflux in infants.
For the most part, drugs that decrease intestinal gas or neutralize stomach acid (antacids) are very safe. At high doses, antacids can cause some side effects, such as diarrhea. Chronic use of very high doses of Maalox or Mylanta may be associated with an increased risk of rickets (thinning of the bones).
Side effects from medications that inhibit the production of stomach acid are uncommon. A small number of children may develop some sleepiness when they take Zantac, Pepcid, Axid, or Tagamet.
Drugs to Improve Intestinal Coordination
Drugs to improve intestinal coordination include:
Propulsid. This drug was voluntarily withdrawn from the U.S. market in 2000 due to an association with abnormal heart rhythms; however, it is still available when prescribed under the guidance of a specialist in gastrointestinal diseases and can be very effective for treating childhood reflux. The drug works by increasing the pressure of the lower esophageal sphincter and increasing emptying of the stomach and the rate that food moves through the intestines. This helps reduce esophageal exposure to stomach contents.
Reglan. This is another medication that helps speed up the digestion process. However, it is also associated with many side effects, some of which can be serious. As a result. it is rarely prescribed.
Erythromycin. This is an antibiotic usually used to treat bacterial infections. One common side effect of erythromycin is that it causes strong stomach contractions. This side effect is advantageous when the drug is used to treat reflux.
Surgery for Acid Reflux in Babies and Kids
Surgery isn't often needed to treat acid reflux in babies and kids. When it is necessary, the Nissen fundoplication is the most often performed surgery. During this procedure, the top part of the stomach is wrapped around the esophagus forming a cuff that contracts and closes off the esophagus whenever the stomach contracts -- preventing reflux.
The procedure is usually effective, but it is not without risk. Discuss the potential risks and benefits of this operation with your child's doctor.