Speed of healing and symptom relief in grade II to IV gastroesophageal reflux disease: A meta-analysis

Chiba, Naoki; Gara, CJ De; Wilkinson, JM; Hunt, R. H.

doi:10.1053/gast.1997.v112.pm9178669

Cited by 778 publications

(588 citation statements)

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“…PPI therapy is proven effective for healing esophagitis in adults (13)(14)(15), for reducing acid exposure in infants (16)(17)(18) and is suggested to heal erosive esophagitis in 89% of children (19). However PPIs have not been proven to relieve symptoms of GERD in infants (20)(21)(22).…”

Section: Introductionmentioning

confidence: 99%

Esophageal impedance baselines in infants before and after placebo and proton pump inhibitor therapy

Loots

Wijnakker

Wijk

et al. 2012

Neurogastroenterology Motil

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Section: Introductionmentioning

confidence: 99%

Esophageal impedance baselines in infants before and after placebo and proton pump inhibitor therapy

Loots

Wijnakker

Wijk

et al. 2012

Neurogastroenterology Motil

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“…3 The reason why only less than one-half of GERD patients develop complicated reflux disease and erosive reflux oesophagitis is not fully understood, but the acidity of the refluxate is undoubtedly critically involved: more rapid and more complete mucosal healing and a greater efficacy in maintaining remission are observed with the more potent acid-suppressing proton pump inhibitors than with H 2 -receptor antagonists. 4,5 However, in some patients, the healing of oesophageal mucosal lesions is not obtained with standard or even double daily dosages of proton pump inhibitors. Nocturnal acid breakthrough, i.e.…”

Section: Introductionmentioning

confidence: 99%

Different patterns of oesophageal acid exposure distinguish complicated reflux disease from either erosive reflux oesophagitis or non‐erosive reflux disease

Frazzoni

Micheli

Savarino

2003

Aliment Pharmacol Ther

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SummaryBackground : The reason why less than one‐half of patients with gastro‐oesophageal reflux disease develop complicated reflux disease (ulcerative oesophagitis, oesophageal strictures and Barrett's oesophagus) and erosive reflux oesophagitis is not fully understood. Supine nocturnal oesophageal acid reflux is considered to be critically involved in this phenomenon, but reliable data are lacking.Aim : To clarify whether high levels of supine nocturnal oesophageal acid exposure are associated with complicated reflux disease.Methods : Ambulatory 24‐h oesophageal pH monitoring was performed in 220 patients with gastro‐oesophageal reflux disease (56 with complicated reflux disease, 76 with erosive reflux oesophagitis and 88 with non‐erosive reflux disease). The total, supine nocturnal and upright diurnal percentage acid reflux times were calculated.Results : The total percentage acid reflux time was significantly greater in complicated reflux disease than in either erosive reflux oesophagitis (P = 0.024) or non‐erosive reflux disease (P = 0.000). These differences were entirely due to a greater supine nocturnal percentage acid reflux time (P = 0.038 and P = 0.000, respectively), whereas no difference was observed in the upright diurnal percentage acid reflux time.Conclusions : Complicated reflux disease is characterized by high levels of supine nocturnal percentage acid reflux time. Prospective studies would be appropriate to clarify whether the normalization of this parameter is relevant to the effective management of this subset of patients with gastro‐oesophageal reflux disease.

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“…On the other hand, studies on adults have confirmed the superiority of PPI over H2RA for healing severe esophagitis. 30,31 Studies with this class of drugs in children have primarily selected patients based on treatment failure with H2RA, achieving high rates of symptom relief and esophageal mucosa healing. [32][33][34][35] Cucchiara et al compared both drugs in children.…”

Section: The Young Child With Abdominal Painmentioning

confidence: 99%

Tratamento da doença do refluxo gastroesofágico

Guimarães

Marguet

Camargos

2006

J. Pediatr. (Rio J.)

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Objective: To review the literature on the treatment of gastroesophageal reflux disease (GERD) with emphasis on pharmacological aspects. To identify particularities of pharmacological treatment of esophageal and extraesophageal manifestations of the disease.Sources: Electronic search of the PubMed/MEDLINE and Cochrane Collaboration databases. Controlled and randomized studies published since 2000 and reviews representing consensus positions and directives published within the last 10 years were identified. Summary of the findings:The drugs currently available for the treatment of GERD do not act in the primary mechanism of the disease, i.e., transitory relaxation of the lower esophageal sphincter. Pharmacological treatment of GERD with symptoms or with esophageal injury is based on the suppression of acid secretion, particularly with proton pump inhibitors. When the hyperreactivity of the lower airways coexists with esophageal GERD symptoms, suppression of acid secretions should be of benefit in managing the respiratory disease in the presence of a causal relationship; however, this is not usual. When esophageal symptoms are not present, esophageal 24-hour pH study should be carried out prior to starting pharmacological treatment for GERD. Improvement of respiratory symptoms may be delayed with relation to esophageal symptoms. It is common for GERD to recur and pharmacological treatment should be repeated or continued indefinitely, depending on clinical presentation of the disease. Conclusions:The strategies that have been proposed for the pharmacological treatment of GERD in children are primarily based on studies of case series or on studies with adults. There have been very few controlled and randomized studies in children. Undertaking a greater number of these studies might reinforce existing aspects or establish new aspects of management.J Pediatr (Rio J). 2006;82(5 Suppl):S133-45: Gastroesophageal reflux, child, drug therapy, esophagitis, respiratory tract diseases, asthma. The symptoms of GERD are less common than the symptoms of GER, but, even so, are very prevalent. A prevalence study reported weekly heartburn sensation and acid regurgitation in approximately 2% of children aged 3 to 9 years and in 5% to 8% of 10 to 17 year-olds. REVIEW ARTICLEHeartburn alone was identified in 17.8% of the children in the older age group. 7 In the Western world, the prevalence of GERD among adults has been estimated from 10% to 20%. 5The refluxate may be exclusively acidic or mixed with duodenum-gastric reflux. Acid reflux is easier to identify and consequently the pathophysiology, diagnosis and treatment are better known. The bile reflux is little understood, but it has been related to severe esophagitis. 8 The case of mixed reflux diagnosis is highly problematic, and is one of the limitations of pH studies. There are no specific clinical trials on mixed reflux in the literature. has not specified the classification by age group, and most of the definitions proposed are applicable to adult patients. Notwithstan...

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Speed of healing and symptom relief in grade II to IV gastroesophageal reflux disease: A meta-analysis

Cited by 778 publications

References 3 publications

Esophageal impedance baselines in infants before and after placebo and proton pump inhibitor therapy

Esophageal impedance baselines in infants before and after placebo and proton pump inhibitor therapy

Different patterns of oesophageal acid exposure distinguish complicated reflux disease from either erosive reflux oesophagitis or non‐erosive reflux disease

Tratamento da doença do refluxo gastroesofágico

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