Pharmacological treatment of children with gastro-oesophageal reflux

Abstract

Background Gastro-oesophageal reflux (GOR) is a common disorder, characterised by regurgitation of gastric contents into the oesophagus. GOR is a very common presentation in infancy in both primary and secondary care settings. GOR can affect approximately 50% of infants younger than three months old. The natural history of GOR in infancy is generally that of a functional, self-limiting condition that improves with age; < 5% of children with vomiting or regurgitation continue to have symptoms after infancy. Older children and children with co-existing medical conditions can have a more protracted course. The definition of gastro-oesophageal reflux disease (GORD) and its precise distinction from GOR are debated, but consensus guidelines from the North American Society of Gastroenterology, Hepatology and Nutrition define GORD as 'troublesome symptoms or complications of GOR.' Objectives This Cochrane review aims to provide a robust analysis of currently available pharmacological interventions used to treat children with GOR by assessing all outcomes indicating benefit or harm. Search methods We sought to identify relevant published trials by searching the Cochrane Central Register of Controlled Trials (CENTRAL) (2014, Issue 5), MEDLINE and EMBASE (1966 to 2014),

Use of Gastroesophageal Reflux Medications in Premature Infants After NICU Discharge

“…6,7,11,19 Although there remains a role for these medications in documented reflux disease, empirical treatment of infants is not recommended. 6,7 In addition, adverse outcomes such as community-acquired pneumonia, 20 -22 gastroenteritis, 21,23 lower respiratory tract infections, 12 Clostridium difficile infection, 24,25 alterations in lung microflora, 26 and fractures 27,28 have been reported with the use of acidblocking medications.…”

Tos persistente y neuropatía laríngea

“…En cuanto a las medidas farmacológicas, dentro del tratamiento inicial de la tos persistente se debe considerar el reflujo extraesofágico y su terapia con inhibidores de bomba de protones (IBP) dividida en dos dosis diarias y administrada entre 30 y 60 minutos antes de las comidas (se ha demostrado que esto aumenta la eficacia del tratamiento) [18][19][20][21] . Se debe ajustar su dosis hasta lograr control o desaparición de los síntomas y luego mantener el tratamiento hasta 3 meses posresolución de los síntomas.…”

Advances in Pediatric Pharmacology, Therapeutics, and Toxicology

“…GERD in infancy is generally self-limiting and improves with age while older children who develop GERD along with other medical co-morbidities tend to experience a more prolonged disease course [38, 39]. Rabeprazole (Achipex), a proton pump inhibitor (PPI), was approved for the treatment of GERD in adolescents 12–17 years of age in 2008 [1].…”