Omeprazole in infants with cimetidine-resistant peptic esophagitis☆,☆☆,★
Section snippets
Methods
Twelve neurologically normal infants (age 2.9 ± 0.9 months) with grade 2 peptic esophagitis not responding to cimetidine were treated with omeprazole, 0.5 mg/kg (which equals 20 mg/day per 1.73 m2), once a day for 6 weeks. All patients but one had been receiving cimetidine (10 mg/kg three times a day) after endoscopy for at least 2 weeks plus cisapride (0.8 mg/kg per day in three divided doses before meals) and Gaviscon (a combination of an antacid and sodium salt of alginic acid, 1 to 2 gm/100
Results
The clinical symptoms before and during treatment with omeprazole are shown in Table I.
Empty Cell Before 48 hr after 6 wk Vomiting 4 3 1 Nonregurgitant reflux 10 7 2 Crying during/after feeding 12 4 1 Irritability 10 6 0 Feeding refusal (after ± 50 ml) 8 3 0
Discussion
Our data suggest that omeprazole, which inhibits the final step (H+/K+ ATPase) in gastric acid release from the parietal cell, is an effective therapy for histamine receptor type 2 antagonist-resistant peptic esophagitis in neurologically normal infants.
Dosages of omeprazole ranging between 20 and 40 mg/m2/day have been used in children. In this study we evaluated 0.5 mg/kg/day, which is approximately 20 mg/m2/day. This dosage clearly resulted in an effective decrease in symptoms, endoscopic
References (14)
Esophageal biopsy in the diagnosis of reflux esophagitis
J Pediatr Surg
(1981)- et al.
Effect of omeprazole in the treatment of refractory acid-related diseases in childhood: endoscopic healing and twenty-four-hour intragastric acidity
J Pediatr
(1996) Gastroesophageal reflux: one reason why baby won’t eat
J Pediatr
(1994)- et al.
Thickened feedings as a cause of increased coughing when used as therapy for gastroesophageal reflux in infants
J Pediatr
(1992) Reflux esophagitis in infants and children: a report from the working group on gastro-oesophageal reflux disease of the European Society of Paediatric Gastroenterology and Nutrition
J Pediatr Gastroenterol Nutr
(1994)- et al.
L’oesophage: manuel et atlas d’endoscopie
(1977) - et al.
Histologic evaluation of chronic gastroesophageal reflux: an evaluation of biopsy methods and diagnostic criteria
Dig Dis Sci
(1984)
Cited by (42)
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2015, Complementary Therapies in Clinical PracticeCitation Excerpt :In both treatments group weight gain was detected (Table 4). Although weight gain is related to the expected growth age in these children, however, this can be due to decline in gastroesophageal symptoms and consequently increase food intake or stimulation of appetite [35,44,50]. In addition, there are several complementary and alternative treatments which were evaluated for their effects on GERD symptoms.
Gastroesophageal Reflux Disease
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2005, Farmacia HospitalariaProton pump inhibitors in children: A review
2003, Digestive and Liver DiseaseAn update on the latest chemical therapies for reflux esophagitis in children
2019, Expert Opinion on Pharmacotherapy
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From the Department of Pediatrics, Virga Jesse Hospital, Hasselt, Belgium.
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Reprint requests: Philippe Alliët, MD, Department of Pediatrics, Virga Jesse Hospital, Stadsomvaart 11, B-3500 Hasselt, Belgium.
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