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Symptoms of gastroesophageal reflux disease in children
Medical expert of the article
Last reviewed: 04.07.2025
In the structure of clinical symptoms of gastroesophageal reflux disease in children, esophageal and extraesophageal symptoms are distinguished.
Esophageal symptoms include heartburn, regurgitation, the "wet spot on the pillow" symptom, belching (air, sour, bitter), periodic chest pain, pain or discomfort when food passes through the esophagus (odynophagia), and dysphagia. The severity of these symptoms in children is determined primarily by the state of the motor function of the lower esophageal sphincter, rather than the morphological state of the esophageal mucosa.
Extraesophageal symptoms are mainly associated with the involvement of the bronchopulmonary, cardiovascular systems and ENT organs. According to various authors, the frequency of gastroesophageal reflux in bronchial asthma in children ranges from 55 to 80%. There is evidence of a connection between the development of gastroesophageal reflux and chronic pneumonia, recurrent and chronic bronchitis, cystic fibrosis. Bronchial obstruction associated with gastroesophageal reflux may be suspected in children with attacks of coughing or suffocation mainly at night, after a large meal. It is also necessary to take into account the complex of respiratory and esophageal symptoms, the presence of a positive effect from trial antireflux therapy, a protracted course and non-atopic nature of bronchial asthma, despite adequate treatment.
Otolaryngological symptoms include constant coughing, a feeling of irritation in the throat, hoarseness, ear pain, and frequent otitis.
A connection has been established between gastroesophageal reflux and enamel erosion and caries development. Cardiovascular symptoms associated with gastroesophageal reflux include arrhythmia due to initiation of the esophagocardial reflex, and pain in the heart region.
At an early age, gastroesophageal reflux disease manifests itself with regurgitation in combination with weight loss, projectile vomiting with blood or bile is possible, respiratory disorders up to apnea and sudden death syndrome are encountered. With a hiatal hernia, unusual movements of the head and neck associated with episodes of reflux (Sandifer syndrome) are possible.
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