Digestive and Gastrointestinal Conditions

Gastroesophageal Reflux Symptoms and Diagnosis

Symptoms of Gastroesophageal Reflux Disease (GERD)

Your baby may have one or more of these symptoms of gastroesophageal reflux:

  • Frequent spitting up or vomiting
  • Coughing, choking, gulping swallows, or trouble breathing if spit-up is in their throat
  • Fussiness or crying throughout the day, especially one to two hours after feeding
  • Restless sleep, or waking often from discomfort
  • Changes in breathing patterns or long pauses in breathing (apnea)
  • In older children, problems such as asthma or chronic sinus trouble can be linked to gastroesophageal reflux.

Symptoms tend to be worse when your baby is lying flat and tend to improve when the baby is sitting or held upright.

Gastroesophageal reflux can cause other health problems that have their own symptoms:

  • Babies who vomit often may not gain weight, or may even lose weight.
  • If spit-up gets into your baby's windpipe (trachea), it may go into the lungs. This is called aspirating. It can lead to pneumonia, bronchitis or wheezing.
  • If the esophagus is irritated over and over by acid, a scar may develop. This can cause narrowing in the esophagus (stricture) and make it hard to swallow.

Gastroesophageal Reflux Diagnosis

To diagnose gastroesophageal reflux, doctors start by asking questions about your child's symptoms and feeding patterns. Sometimes the answers are enough to diagnose reflux.

If the doctor needs more information, your baby may have a series of X-rays called an upper GI (PDF 48KB) (gastrointestinal) series. First your baby will swallow a liquid that shows up on the X-ray. This liquid helps show how well food travels to and stays in the stomach. Doctors order an upper GI series mainly to look for structural, or anatomic, problems that might be causing reflux.

A common test for babies who might have reflux is a pH probe study. A thin tube with a sensor is passed through your baby's nose into the esophagus. The probe measures the level of acid there. This test usually lasts 24 hours and is done in the hospital. Babies must stop taking antacid medications for a minimum of 24 hours before the test.