Antacids and cimetidine treatment for gastro-oesophageal reflux and peptic oesophagitis.

Cucchiara, Salvatore; Staiano, Annamaria; Romaniello, Gabriela; Capobianco, Stephanie; Auricchio, S

doi:10.1136/adc.59.9.842

Cited by 71 publications

(35 citation statements)

References 25 publications

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“…7 All clinicians should also recognize that the metabolism of PPIs is known to differ in children compared with adults, with a trend toward a shorter half-life, necessitating a higher per-kilogram dose to achieve a peak serum concentration 47 Lansoprazole, 0.7 to 3.0 mg/kg daily, improved GERD symptoms and healed all cases of erosive esophagitis in the treatment of 1-to 12-year-old children with GERD. 48 Other trials of PPI therapy support the efficacy of treatment of severe esophagitis and esophagitis refractory to H2RAs in children. 4,45 As in adults, PPIs are considered safe and generally well tolerated with relatively few adverse effects.…”

Section: Ppismentioning

confidence: 99%

“…There is limited historical evidence that on-demand use of antacids can lead to symptom relief in infants and children. 48 Instead, although antacids are generally seen as a relatively benign approach to treating pediatric GERD, it is important to recognize that they are not entirely without risk. Indeed, several studies link aluminumcontaining preparations with aluminum toxicity and its complications in children.…”

Section: Antacidsmentioning

confidence: 99%

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Gastroesophageal Reflux: Management Guidance for the Pediatrician

Lightdale¹,

Gremse²,

2013

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Recent comprehensive guidelines developed by the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition define the common entities of gastroesophageal reflux (GER) as the physiologic passage of gastric contents into the esophagus and gastroesophageal reflux disease (GERD) as reflux associated with troublesome symptoms or complications. The ability to distinguish between GER and GERD is increasingly important to implement best practices in the management of acid reflux in patients across all pediatric age groups, as children with GERD may benefit from further evaluation and treatment, whereas conservative recommendations are the only indicated therapy in those with uncomplicated physiologic reflux. This clinical report endorses the rigorously developed, well-referenced North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines and likewise emphasizes important concepts for the general pediatrician. A key issue is distinguishing between clinical manifestations of GER and GERD in term infants, children, and adolescents to identify patients who can be managed with conservative treatment by the pediatrician and to refer patients who require consultation with the gastroenterologist. Accordingly, the evidence basis presented by the guidelines for diagnostic approaches as well as treatments is discussed. Lifestyle changes are emphasized as first-line therapy in both GER and GERD, whereas medications are explicitly indicated only for patients with GERD. Surgical therapies are reserved for children with intractable symptoms or who are at risk for life-threatening complications of GERD. Recent black box warnings from the US Food and Drug Administration are discussed, and caution is underlined when using promoters of gastric emptying and motility. Finally, attention is paid to increasing evidence of inappropriate prescriptions for proton pump inhibitors in the pediatric population.

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Section: Ppismentioning

confidence: 99%

Section: Antacidsmentioning

confidence: 99%

Gastroesophageal Reflux: Management Guidance for the Pediatrician

Lightdale¹,

Gremse²,

2013

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“…H 2 -receptor antagonists, such as cimetidine (Tagamet), ranitidine (Zantac) and famotidine (Pepcid), are effective in healing reflux oesophagitis in infants [28,32,88]. High-dose ranitidine appears to be comparable to omeprazole in this respect [34].…”

Section: Antacids H 2 -Receptor Antagonists and Proton Pump Inhibitorsmentioning

confidence: 99%

“…Their effects on regurgitation are not well documented. Intensive antacid treatment with large quantities has been shown as effective as cimetidine in reducing pH-metric parameters and in healing oesophagitis [28]. However, their efficacy in buffering gastric acidity in infants is strongly influenced by the time of administration [118] and requires multiple administrations.…”

Section: Antacids H 2 -Receptor Antagonists and Proton Pump Inhibitorsmentioning

confidence: 99%

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A critical appraisal of current management practices for infant regurgitation - recommendations of a working party

Vandenplas

Belli²,

Benhamou

et al. 1997

European Journal of Pediatrics

126

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A critical appraisal of current management practices for infant regurgitation: recommendations of a working party Vandenplas, Y.; Belli, D.; Benhamou, P.; Cadramel, S.; Cezard, J.P.; Cucchiara, S.; Dupont, C.; Faure, C.; Gottrand, F.; Hassall, E.; Heymans, H.S.A.; Kneepkens, C.M.F.; Sandhu, B. Published in:European Journal of Pediatrics DOI:10.1007/s004310050613Link to publication Citation for published version (APA):Vandenplas, Y., Belli, D., Benhamou, P., Cadramel, S., Cezard, J. P., Cucchiara, S., ... Sandhu, B. (1997). A critical appraisal of current management practices for infant regurgitation: recommendations of a working party. European Journal of Pediatrics, 156, 343-357. DOI: 10.1007/s004310050613 General rightsIt is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an open content license (like Creative Commons). Disclaimer/Complaints regulationsIf you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Abstract Regurgitation is a common manifestation in infants below the age of 1 year and a frequent reason of counselling of general practitioners and paediatricians. Current management starts with postural and dietary measures, followed by antacids and prokinetics. Recent issues such as an increased risk of sudden infant death in the prone sleeping position and persistent occult gastrooesophageal reflux in a subset of infants receiving milk thickeners or thickened ''anti-regurgitation formula'' challenge the established approach. Therefore, the clinical practices for management of infant regurgitation have been critically evaluated with respect to their efficacy, safety and practical implications.

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Rationale and Efficacy of Conservative Therapy for Gastroesophageal Reflux Disease

Kitchin

Castell²

1991

Arch Intern Med

121

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Antacids and cimetidine treatment for gastro-oesophageal reflux and peptic oesophagitis.

Abstract: SUMMARY Thirty three children aged 2 to 42 months (mean 9 months) with gastro-oesophageal reflux and peptic oesophagitis took part in a treatment trial comparing cimetidine (20 mg/kg/day) with an intensive regimen of antacids (Maalox, 700 mmol (mEq)/1.73 m2/day

Cited by 71 publications

References 25 publications

Gastroesophageal Reflux: Management Guidance for the Pediatrician

Gastroesophageal Reflux: Management Guidance for the Pediatrician

A critical appraisal of current management practices for infant regurgitation - recommendations of a working party

Rationale and Efficacy of Conservative Therapy for Gastroesophageal Reflux Disease

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