What is the cause of gastroesophageal reflux in children?

Esophageal reflux is a disorder of esophageal function caused by many reasons. It is also a multiple esophageal lesion. Most of the symptoms are repeated. There are several groups of people with esophageal reflux. The elderly are caused by low immunity. Pregnant women, children and young people have different symptoms and different causes of the disease. So what is the cause of esophageal reflux in children?

Gastroesophageal reflux is a disease characterized by the frequent and repeated reflux of gastric contents into the esophagus caused by gastroesophageal motility disorders due to various reasons. From the perspective of etiology, it can be divided into physiological and pathological types. Physiological mainly refers to the spontaneous disappearance caused by relaxation of the lower esophageal sphincter (LES).

A small part of gastroesophageal reflux is caused by congenital defects of the esophageal sphincter, abnormal digestive endocrine function, congenital anatomical malformations of the lower esophagus or gastric cardia (such as esophageal hiatal hernia, diaphragmatic hernia), etc. Most of them are difficult to heal naturally and are pathological. Most of these patients have obvious comorbidities.

Treatment

(I) Reasonable body position and dietary therapy are effective for most physiological children. Most of them adopt inclined supine sleeping position, with high side high position 30°-60° prone. Do not eat 2 hours before going to bed. Eat small meals frequently, with mainly thick foods.

(ii) Drug treatment currently mainly involves the combination of gastric motility agents and antacids. The commonly used gastric prokinetic agent is metoclopramide, with a dose of 0.3 mg/kg, taken 15-30 minutes before meals. There is no appropriate dose for neonates. Metoclopramide can also promote faster gastric excretion, but it is rarely used because it is very likely to cause extrapyramidal reactions.

Cisapride is now widely used, with children taking 0.3 mg/kg, 3 times a day and infants taking 0.15-0.20 mg/kg, 3 times a day. Its effect is more definite than that of metoclopramide. Currently, antacids mostly use H2 receptor antagonists, such as cimetidine or ranitidine, and proton pump inhibitors such as Losec can also be used. People with anemia should be treated with iron supplements.

(III) Surgical treatment: If medical treatment is ineffective after 6 weeks, and the patient has recurrent pneumonia, severe esophagitis, esophageal stenosis, malnutrition, difficult-to-correct anemia or recurrent heavy bleeding, hiatal hernia, etc., surgical treatment should be considered. Currently, Nissen fundoplication is often used, with an efficiency of 95%.

What are the treatments for esophageal reflux in children? First of all, if the condition is serious, surgical treatment can be adopted. If it is not serious, you need to pay attention to diet or take medication. Most of the friends with esophageal reflux have poor gastrointestinal digestion. When choosing food, you can eat small meals frequently and eat more foods that are conducive to digestion.