How is GERD diagnosed in infants and children?

When making any diagnosis a doctor will start with a physical exam of the infant or child and ask about the symptoms that they are displaying. If a doctor suspects your infant or child may be suffering from GER or GERD you may be asked to keep a diary of the amount your infant or child eats and how often they are bringing up their food/milk. In most cases, further testing/investigations are not necessary but if your infant or child is having severe symptoms, further tests may be ordered. These include:

• Lab tests– If an alternate cause for the recurring vomiting or poor weight gain is suspected by the healthcare professional, then urine and/or blood tests may be of benefit.
• Ultrasound scan– This type of imaging uses sound waves to produce images that can be used to identify if the child or infant has pyloric stenosis.
• Oesophageal pH monitoring– In order to determine the acidity of the oesophagus, the infant or child will be asked to swallow a thin, long tube that has a probe at the tip. This will stay in the oesophagus for 24 hours whilst the child or infant is closely monitored (usually whilst staying in the hospital). This tool measures the acidity of the oesophageal contents and can also help to determine whether any breathing problems are caused by GERD.
• Upper GI endoscopy– This test uses a flexible, thin and lighted tube with a camera at the end of it, known as an endoscope. It is passed through the infant or child’s mouth and into the oesophagus, stomach and small intestine. This enables the healthcare professional to visualise any inflammation or problems, especially in the oesophagus. Samples of the tissue can also be taken for analysis. This test is typically done whilst the infant or child is under sedation or anaesthesia.
• X-rays / barium swallow / upper GI series– These are imaging tests that are able to detect any abnormalities within the digestive tract. In some cases, the infant or child is given a contrast liquid known as barium to swallow, which highlights the stomach and oesophagus as well as the upper area of the small intestine.
• Gastric emptying – Some infants and children who have GERD suffer from a slow emptying of their stomach which may be a contributing factor for acid reflux. In this test, the child or infant will drink milk or eat food that has been mixed with a radioactive chemical. This chemical, which is typically harmless to the recipient, is studied as it flows through the digestive tract, using a specialised camera to track it.