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Acid Reflux in Teenagers: Causes, Symptoms, Diagnosis, and Treatment Options

What Is Acid Reflux (GERD)?

Gastroesophageal reflux disease (GERD) occurs when stomach contents frequently flow back into the esophagus, causing symptoms or complications. In teens, prevalence is 5-10%.

Common Causes in Teens

  • Diet: Spicy, fatty, fried foods; chocolate; caffeine; carbonated drinks; citrus; tomato-based foods.
  • Obesity: Increased intra-abdominal pressure.
  • Hiatal hernia: Stomach protrudes through diaphragm.
  • Medications: NSAIDs, antibiotics, bisphosphonates, some asthma meds.
  • Lifestyle: Large meals, lying down after eating, smoking/vaping.
  • Stress/anxiety: Increases acid sensitivity.

Symptoms

  • Heartburn (burning chest pain after meals, worse lying down)
  • Regurgitation (sour/bitter taste in mouth)
  • Dysphagia (difficulty swallowing)
  • Chronic cough, hoarseness, throat clearing (laryngopharyngeal reflux)
  • Dental erosion
  • Chest pain (mimicking cardiac pain)

Diagnosis

  • Clinical history often sufficient.
  • Empiric PPI trial (4-8 weeks).
  • Endoscopy if alarm symptoms (dysphagia, weight loss, bleeding) or refractory.
  • pH/impedance monitoring if diagnosis unclear.

Treatment

Lifestyle Modifications

  • Weight loss if overweight
  • Avoid trigger foods
  • Small, frequent meals
  • Elevate head of bed 6-8 inches
  • No eating 2-3 hours before bed

Medications

  • Antacids (Tums, Maalox) for occasional symptoms
  • H2 blockers (famotidine) for mild GERD
  • PPIs (omeprazole, esomeprazole) for moderate-severe GERD (4-8 week trial)

When to See a Doctor

Symptoms >2 weeks despite OTC meds, alarm symptoms, or interference with daily activities/school.

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