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Drugs for the treatment of gastro-oesophageal reflux: in search of clear evidence-based indications

Department of Paediatrics, Institute of Child Health, IRCCS Burlo Garofolo, Trieste, Italy

Correspondence to:
Federico Marchetti, Department of Paediatrics, Institute of Child Health, IRCCS Burlo Garofolo, Trieste, Italy; fedemarche@tin.it

The first 150 words of the full text of this article appear below.

Keady¹ presents some updated guidelines on the drug treatment of gastro-oesophageal reflux (GOR) and gastro-oesophageal reflux disease (GORD). However, in order to provide clear management guidelines, we believe that the review should have first addressed the definition of GOR (ie, physiological) versus GORD (ie, pathological). In fact, the results of a recent survey on the knowledge, attitudes and practice styles of North American paediatricians regarding GOR show that many infants are still inappropriately treated for GORD when all they have is physiological GOR.² The first important goal of future educational efforts should therefore be directed to avoid over-treatment of "happy spitters" (ie, GOR). Secondly, in his conclusions Keady correctly stresses that "the majority of drugs used have limited robust data supporting their use". However, some evidence from randomised controlled trials (RCTs) is now available, but it is not clearly reflected by the practice guidelines suggested by Keady. An example of . . . [Full text of this article]