Baclofen for the Treatment of Pediatric GERD

Vadlamudi, Narendra B.; Hitch, Meredith C.; Dimmitt, Reed A.; Thame, Kirk A.

doi:10.1097/mpg.0b013e3182a2747b

Cited by 33 publications

(12 citation statements)

References 39 publications

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“…In contrast to adult patients, lifestyle modification is not a first-line treatment since neonates and infants have shorter intra-abdominal oesophagus and their diet is predominantly fluid [11,12]. Regarding medical treatment options, the efficacy for proton pump inhibitor or prokinetics in neonates and infants remained unproven [13,14]. Therefore, fundoplication is indicated to correct GERD in neonates and infants.…”

Section: Discussionmentioning

confidence: 91%

Laparoscopic Nissen fundoplication for gastro-oesophageal reflux disease in infants

et al. 2014

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Section: Discussionmentioning

confidence: 91%

Laparoscopic Nissen fundoplication for gastro-oesophageal reflux disease in infants

et al. 2014

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“…Baclofen was shown to reduce the number of TLSERs and acid GER during a 2-h test period and accelerate gastric emptying [133]. Baclofen can be used as a supplemental therapy to PPIs in children with refractory GER, although failure rate is around 33 % [134]. The data on baclofen are very limited, and the high incidence of adverse events does not justify its widespread use.…”

Section: Prokinetics and Other Nonacid Reducing/blocking Medicationmentioning

confidence: 98%

Gastroesophageal Reflux

Vandenplas¹

2015

Textbook of Pediatric Gastroenterology, Hepatology and Nutrition

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“…In 11 patients, the pressure of the R wave was <30 mm Hg (range [19][20][21][22][23][24][25][26][27]. Given that the adult definition stipulates that the R waves needs to have 30 mm Hg, 12 we compared the rumination episode characteristics between those with a R wave pressure of <30 mm Hg and those with R waves >30 mm Hg.…”

Section: Characteristics Of the R Wavesmentioning

confidence: 99%

Pediatric rumination subtypes: A study using high‐resolution esophageal manometry with impedance

Rosen

Rodriguez

Nurko

2016

Neurogastroenterology Motil

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Background The differential diagnosis of intractable reflux in children includes rumination syndrome but confirming the diagnosis using antroduodenal manometry is invasive, costly and requires anesthesia. High resolution esophageal manometry with impedance (HRM-MII) overcomes these limitations and the goal of this study is to validate the use of HRM-MII as a diagnostic tool for rumination and to describe the subtypes of pediatric rumination. Methods We reviewed the HRM-MII tracings of 21 children presenting with symptoms of intractable reflux in whom rumination was being considered. Patients underwent a standard and post-prandial HRM-MII. Peak intraluminal esophageal pressures, baseline gastric and thoracic pressures, and the timing of the R wave relative to LES relaxations and bolus flow were recorded. Chi square analyses were used for comparison of proportions and means were compared using t-tests or non-parametric equivalent. Key Results Forty one (55.5%) primary and 33 (44.5%) secondary rumination episodes were seen. Three types of primary rumination were identified: 1) LES relaxation without retrograde flow preceding the R wave (51% of episodes); 2) LES relaxation after the R wave (20% of episodes); and 3) R waves with no LES relaxation (29% of episodes). Eleven patients had rumination episodes with a peak gastric pressure <30 mm Hg. A total of 44 (60%) rumination episodes occurred during the standard HRM-MII, and 30 (40%) occurred during or after the meal. Conclusions and Inferences HRM-MII can accurately diagnose rumination in children. We identify three types of primary rumination which may provide insight into therapeutic response.

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Baclofen for the Treatment of Pediatric GERD

Abstract: Baclofen can be used as supplemental therapy to proton pump inhibitors in children with refractory GER; however, prospective trials are needed to further validate our results and assess safety.

Cited by 33 publications

References 39 publications

Laparoscopic Nissen fundoplication for gastro-oesophageal reflux disease in infants

Laparoscopic Nissen fundoplication for gastro-oesophageal reflux disease in infants

Gastroesophageal Reflux

Pediatric rumination subtypes: A study using high‐resolution esophageal manometry with impedance

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