Significant GER takes place when this valve is either chronically lax or when it relaxes in a brief but frequent, spontaneous manner. Infants are more susceptible to this kind of abnormal GER and almost one in 300-1000 infants suffer from it. Children with cerebral palsy, mental retardation and Down's syndrome are more likely sufferers. Frequent regurgitation or vomiting is the most common symptom. The quantity of vomited contents may be small or large and the nature of vomiting although mostly passive, can be very forceful.
Older children can tell about heartburn or burning pain in the middle of chest.
Infants can start sudden unexpected crying some time after food. Irritability, inability to sleep soundly, inability to tolerate certain foods, frequent choking or gagging after food, frequent sore throats, frequent chest infections, wheezing, chronic cough and poor growth are sometimes the only indicators. Due to constant exposure of acidic stomach contents, the inner lining of the food pipe gets inflamed resulting in condition called oesophagitis'. In severe cases, there can be a stricture formation i.e. permanent narrowing of the food pipe. Inability to retain nutrients leads to growth failure.