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Reflux Disorders in Children

Reflux is a disorder in which urine backs up (refluxes) from the bladder to the kidney. The amount of reflux can be large or small.

What causes reflux?

In the human urinary tract there is a valve where the bladder joins the urine tube, or ureter, that comes from the kidney. Some children are born with a problem valve that does not close properly, so the urine refluxes back into the kidney. Other problems, called voiding disorders, cause problems controlling urine release and may also cause reflux. Some of these problems will disappear as your child gets older.

How is reflux diagnosed? Are there signs to alert parents to the problem?

Usually, reflux is found when you take your child to 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 notice that your child:

  • goes to the bathroom more often
  • says, "It burns" or "It hurts" when urinating
  • says, "My stomach hurts"
  • has a fever.

Take your child to a doctor, who will get a urine culture if he or she suspects an infection.

How is reflux treated?

Reflux can be corrected by surgery. However, most children will get better as they grow older. Therefore, your child may be treated with antibiotics to prevent infection. Only one child in ten will contract an infection when taking antibiotics.

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 pediatric urologist, who specializes in reflux conditions in children. Most American children's hospitals have one of these doctors on staff.

The doctor should evaluate other possible causes of reflux, such as voiding disorders, which usually cause a loss of bladder control. Some children's hospitals have training programs to help children develop better urination control.

Do children with reflux tend to have serious problems later?

Once the reflux condition is corrected, it is very rare for a child to contract it again. However, if the kidneys have been damaged, high blood pressure may surface 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, but some do. A small number will go on to have kidney failure later in life.

Is research being done to find better ways of preventing and treating this problem?

Yes. Researchers are trying to find easier ways to combat reflux. In the future, incision-free, outpatient surgery may be available where a tube inserted into the body allows a doctor to look into and study the bladder.

Is there anything else parents should know about this problem?

Yes. If your child has a fever, complains about pain below the navel 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 look for reflux.

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