Reflux Disorders in Children

What is reflux? What causes it?
Your child can be born with a problem valve in the bladder. The valve is found where the bladder joins the urine tube (ureter) that comes from the kidney. The valve does not close properly so urine backs up (refluxes) from the bladder to the kidney. The amount of reflux can be large or small.

Other problems, called voiding disorders, cause problems controlling urine and may also cause reflux. Some of these will go away as your child gets older.

How is reflux diagnosed? Are there signs to alert parents to the problem?
This problem is usually found when you take your child to see the doctor after a urinary tract infection. About 50 percent of babies and 30 percent of older children with infections will have reflux. The back-flow of urine to the kidney can cause a urinary infection to spread to the kidney, which can make your child very sick and can lead to kidney damage. You may see that your child:

  • goes to the bathroom more often
  • says "It burns or hurts" when passing urine
  • says "My belly hurts"
  • has a fever

You need to take your child to a doctor who will get a urine culture if he suspects an infection.

How is reflux treated?
It can be corrected by surgery. However, most children will get better as they grow older. Therefore, your child may be treated with special medicines (antibiotics) to prevent infection. Only one child in ten will get an infection when taking medicine.

Sometimes, it is hard to decide what is best for your child. If your doctor suggests surgery, you may want to get a second opinion from a doctor who specializes in the care of reflux, called a pediatric urologist.

Most American children's hospitals have one of these doctors.

It is important for the doctor to evaluate other possible causes of reflux, such as voiding disorders, which usually cause problems with wetting. Some children's hospitals have training programs to help children develop better urine control.

Do children with this problem generally do okay or do they tend to have serious problems later?
Children with this problem usually do very well. Once the problem is corrected, it is very rare for it to happen again. However, if the kidneys have been damaged, high blood pressure may occur later in life. The risk of high blood pressure is about 10 percent if one kidney has been damaged and about 20 percent if both kidneys have been damaged. Most children do not have serious kidney damage from reflux. However, some do. A small number will go on to have kidney failure in later life.

Is research being done to find better ways of preventing and treating this problem?
Yes. Researchers are trying to find easier ways to correct the reflux. In the future, surgery may be done without an incision through a tube that allows the doctor to look into the bladder. This type of surgery would be done on an outpatient basis so that your child does not need to stay in the hospital.

Is there anything else that parents should know about this problem?
Yes. If your child gets a fever, complains about belly pain or pain when urinating, or if the child goes to the bathroom more often than usual, he or she may have a urinary infection. A urine culture should always be done and most doctors will also order x-rays to detect reflux, which is a common problem in children with urinary tract infections.

More than 20 million Americans-one in nine adults-has chronic kidney disease, and most don't even know it. More than 20 million others are at increased risk. the National Kidney Foundation, a major voluntary health organization, seeks to prevent kidney and urinary tract diseases, improve the health and well-being of individuals and families affected by these diseases, and increase the availability of all organs for transplantation. Through its 51 affiliates nationwide, the foundation conducts programs in research, professional education, patient and community services, public education and organ donation. The work of the National Kidney Foundation is funded by public donations.