Goblins Go "Owwww"

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st comes Halloween, then, as any parent of a trick-or-treating child can tell you, comes indigestion. But sometimes what passes for a stomachache can be something far more serious: gastro-esophageal reflux disease, or GERD. Well known to adults as heartburn, this disorder of the stomach and esophagus can also strike children, especially if they eat large quantities of chocolate, peppermint or spearmint candies. These treats tend to open up the valve between the esophagus and the stomach and allow food mixed with acid to pass back into the food pipe, causing the uncomfortable burning sensation in the chest that gives heartburn its name.

Most of us think of heartburn as a nuisance, but if left untreated it can lead to major problems, including difficulty swallowing, pneumonia and, eventually, esophageal cancer, according to Dr. Paulo Pacheco, clinical assistant professor of gastroenterology at Weill Medical College of Cornell University and author of Living with Chronic Heartburn (Healthy Living Books; 2003).

With kids, heartburn can be tricky to diagnose — especially with children too young to describe the pain they're feeling. It's up to the parents to watch for telltale signs: episodes of vomiting, inability to sleep, a persistent sour taste in the mouth, bad breath and chronic coughing. Other clues may be the onset of pain soon after a child lies down or a hoarse voice when a child wakes up.

If it is GERD, there are a number of steps you can take. Elevating the head of the bed and having the child lie on the left side at night — which tips the stomach so gravity can hold the acid in — seems to help. Meanwhile, kids should cut down on soda and citrus products and stay away from secondhand smoke. They should also avoid pants or skirts with waistbands that are too tight.

If symptoms persist, your child may have to take medication, but check with your pediatrician before starting even something as seemingly harmless as an antacid.

Dr. Gupta is a neurosurgeon and CNN medical correspondent