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Pediatric use of proton-pump inhibitors

D A Leiman, B P Riff, S Morgan, D C Metz, G W Falk, B French, C A Umscheid, J D Lewis
In patients with gastroesophageal reflux disease (GERD) and erosive esophagitis, treatment with proton pump inhibitors (PPIs) is highly effective. However, in some patients, especially those with non-erosive reflux disease or atypical GERD symptoms, acid suppressive therapy with PPIs is not as successful. Alginates are medications that work through an alternative mechanism by displacing the post-prandial gastric acid pocket. We performed a systematic review and meta-analysis to examine the benefit of alginate-containing compounds in the treatment of patients with symptoms of GERD...
September 26, 2016: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Sofía Verdaguer D, Juan Cristóbal Gana A
BACKGROUND: There is a paucity of good quality research about the diagnosis of esophageal varices and the prophylaxis and treatment of variceal bleeding in pediatric patients with portal hypertension There is little consensus and practically no evidence-based approach about the management of these patients. AIM: To describe the behavior and preferences of pediatric gastroenterologists in Chile in the management of portal hypertension in children. MATERIAL AND METHODS: An online survey was sent to Chilean pediatric gastroenterologists, with questions evaluating the physicians’ approaches to screening of esophageal varices in children with portal hypertension, and their preferred methods of prophylaxis and initial management of variceal bleeding...
July 2016: Revista Médica de Chile
Mehmet Gündüz, Pınar Yamaç, Gökhan Baysoy
Gastroesophageal reflux disease is an important cause of morbidity in childhood. Although various diagnostic methods are available, short course of empiric treatment with a proton pump inhibitor is widely used in adults as a diagnostic test. Data about empiric treatment is scarce in children. The aim of this study is to evaluate the effectiveness of empiric treatment of reflux-like symptoms in children. Pediatric gastroenterology outpatient files were searched and patients with a diagnosis of gastroesophageal reflux were found...
September 2015: Turkish Journal of Pediatrics
Thurid Ahlenstiel-Grunow, Nele K Kanzelmeyer, Kerstin Froede, Martin Kreuzer, Jens Drube, Christian Lerch, Lars Pape
BACKGROUND: Nephropathic cystinosis is a rare lysosomal storage disease which is characterized by the accumulation of free cystine in lysosomes and subsequent intracellular crystal formation of cystine throughout the body. If not treated with cysteamine, a cystine-depleting agent, end-stage renal disease will develop early, followed by multiple organ failure as the disease progresses. The established cysteamine formulation requires a strict dosing regimen at 6-h intervals. An extended release (ER) twice-daily formulation has recently been developed...
June 27, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Jonathan L Slaughter, Michael R Stenger, Patricia B Reagan, Sudarshan R Jadcherla
OBJECTIVE: To determine treatment frequency and duration of histamine-2 receptor antagonist (H2RA)/proton pump inhibitor (PPI) use among infants hospitalized within US children's hospital neonatal intensive care units and evaluate diagnoses/demographic factors associated with use. STUDY DESIGN: We retrospectively analyzed a cohort of neonatal intensive care unit infants admitted to 43 US children's hospitals within the Pediatric Health Information System database between January 2006 and March 2013 to determine H2RA/PPI treatment frequency, timing/duration of treatment, factors associated with use, percent of infants remaining on treatment at discharge, and interhospital prescribing variation...
July 2016: Journal of Pediatrics
Tido von Schoen-Angerer, René Madeleyn, Helmut Kiene, Gunver S Kienle, Jan Vagedes
The association between gastroesophageal reflux disease (GERD) and asthma, although well established in adults, is less strong in the pediatric age group. Benefits of proton pump therapy are limited across age ranges. While there is a growing body of literature on the use of complementary treatments for both asthma and GERD, few studies have focused on treatment benefits for the GERD-asthma association. We present the case of a 2-year-old boy with asthma and GERD who was not responding to inhaled, low-dose corticosteroids, beta-mimetic therapy, and a 6-week course of proton pump inhibitor treatment...
January 2016: Global Advances in Health and Medicine: Improving Healthcare Outcomes Worldwide
Sandeep Lamoria, Arka De, Somya Agarwal, Brinder Mohan Singh Lamba, Vishal Sharma
Barrett's esophagus (BE) is characterized by the replacement of distal esophageal stratified squamous epithelium by columnar epithelium. It is rare in children and the risk factors may include mental retardation, cerebral palsy, esophageal atresia, etc. Apart from corrosive ingestion, peptic stricture is the other leading cause of esophageal strictures in children. However, BE has not been well characterized in the pediatric population and in children presenting with esophageal strictures. A 16-year-old Indian boy presented with a history of gradually progressive dysphagia to solids (but not liquids) for 12 years along with heartburn and poor weight gain...
February 27, 2016: International Journal of Adolescent Medicine and Health
Andrea Maccioni, Jaime Cerda, Claudia Terrazas, Katia Abarca
BACKGROUND: Clostridium difficile (CUj-associated disease (CDAD) and the role of the hypervirulent strain NAP1 have not been well characterized in Pediatrics. AIMS: To describe clinical features of CDAD, and to estimate NAP1 frequency and association with disease severity in Pediatrics. METHODS: Descriptive, transversal surveillance of diarrheal episodes in Chilean children, hospitalized between February 2012 and December 2013, positive for CD by molecular diagnosis...
October 2015: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
Benjamin D Gold, Mark A Gilger, Steven J Czinn
Helicobacter pylori (H pylori) is a common chronic bacterial infection that is an important cause of peptic ulcer disease and gastroduodenal disease in children. H pylori is also associated with extragastric manifestations, including growth reduction, iron-deficiency anemia, and idiopathic thrombocytopenic purpura. Current guidelines recommend endoscopy with biopsy for the definitive demonstration of H pylori infection. In contrast to serology, the fecal antigen test and the urea breath test provide reliable, sensitive, and specific results for detecting active H pylori infection in children before and after treatment...
December 2014: Gastroenterology & Hepatology
Marc Bardou, Kyle J Fortinsky
INTRODUCTION: The management of gastro-esophageal reflux and esophagitis in infants and children is challenging, and there are currently no clear practice guidelines. Given a paucity of evidence in the treatment of pediatric esophagitis, there are concerns over both the efficacy and safety of proton-pump inhibitors, histamine type 2 receptor antagonists, and prokinetics. AREAS COVERED: Comprehensive data from randomized-controlled trials, meta-analyses and observational studies have helped to illustrate the efficacy and safety of various pharmacologic and non-pharmacologic treatments in pediatric esophagitis...
July 2015: Expert Opinion on Drug Safety
Asuncion G Ramos-Soriano, Jimmy Black
Helicobacter pylori, a Gram-negative bacterium found in the human stomach, is often present in patients with chronic gastritis. Traditional treatment for H. pylori infection includes metronidazole or clarithromycin, both being associated with development of resistance. In this retrospective report, we describe our clinical experience using a multi-drug treatment regimen for pediatric H. pylori that included nitazoxanide, a newer nitrothiazole benzamide compound used in treating intestinal protozoa infections...
January 2015: Case Reports in Gastroenterology
Diana Felton, Naamah Zitomersky, Shannon Manzi, Jenifer R Lightdale
Cyclic vomiting syndrome (CVS) is a well-established cause of recurrent vomiting in the pediatric population. Severe vomiting with chronic cannabis use, known as cannabinoid hyperemesis syndrome, has recently been more widely recognized as an etiology of persistent episodic vomiting. In turn, patients presenting with frequent episodes of CVS are now increasingly being screened for cannabinoid use. Because patients with persistent vomiting are also frequently prescribed a proton pump inhibitor (PPI) for their gastrointestinal symptoms, it is important to be aware of the potential for a PPI to cause an interaction that can lead to false-positive urine cannabinoid screening...
April 2015: Pediatrics
Katelyn E Brown, Chad A Knoderer, Kristen R Nichols, Ashley S Crumby
BACKGROUND: Acid-suppressing agents have been associated with increased Clostridium difficile infection (CDI) in adults. The objective of this study was to evaluate the association of acid-suppressing therapy with the development of CDI in the pediatric population. METHODS: This was a retrospective case-control study. Children aged 1 through 17 years with a positive C difficile polymerase chain reaction (PCR) result obtained between June 1, 2008, and June 1, 2012, were randomly matched to a control population selected from patients with negative PCR...
October 2015: Clinical Pediatrics
Efrat Broide, Haim Shirin
Carbon-labeled urea breath tests, which have high sensitivity and specificity, are the preferred method used in epidemiological studies, screening dyspeptic patients and assessing eradication or recurrence of Helicobacter pylori infection. The principle of the (13)C-urea breath test relies upon the ability of the H. pylori urease to hydrolyze the orally administered (13)C-urea. The BreathID (Exalenz Bioscience Inc., Union, NJ, USA) provides a competitive solution for breath testing, including unique features such as automatic continuous breath collection and analysis...
March 2015: Expert Review of Molecular Diagnostics
Ting Wen, Evan S Dellon, Fouad J Moawad, Glenn T Furuta, Seema S Aceves, Marc E Rothenberg
BACKGROUND: Esophageal eosinophilia can be proton pump inhibitor (PPI) resistant or responsive, representing 2 entities known as eosinophilic esophagitis (EoE) and PPI-responsive esophageal eosinophilia (PPI-REE), respectively. Although they present with similar clinical features, EoE is accepted to be an antigen-driven, TH2-associated allergic disorder, whereas the cause of PPI-REE remains a mystery. OBJECTIVE: In this study, our aim was to investigate the pathogenesis of PPI-REE by using a recently described EoE diagnostic panel (EDP) composed of a set of 94 esophageal transcripts and to determine whether PPI therapy reverses any esophageal transcriptional abnormalities...
January 2015: Journal of Allergy and Clinical Immunology
John J Lima, James P Franciosi
The use of proton pump inhibitors (PPIs) in the treatment of gastroesophageal reflux and related diseases is increasing, especially in the pediatric population. Prolonged use of PPIs has been associated with several adverse effects, including potentially life-threatening gastric and respiratory infections, which are related to dose or to the degree of gastric acid suppression. Genetic variation in the CYP2C19 gene gives rise to poor and extensive metabolizer phenotypes, which influence PPI clearance, efficacy and exposure...
August 2014: Pharmacogenomics
M Cofini, P Favoriti, F Quadrozzi
AIM: The aim of this study was to report our experience about clinical presentation and management in children with mild and sever acute pancreatitis (PA). METHODS: At the onset of clinical manifestations the following laboratory and instrumental tests were performed to all patients: abdominal ultrasonography, measurement of blood amylase and lipase and PCR; preventive antibiotic therapy, gabexate mesylate and proton pump inhibitors were also administrated to all patients...
August 2014: Minerva Pediatrica
Sarah C McLeay, Bruce Green, William Treem, An Thyssen, Erik Mannaert, Holly Kimko
BACKGROUND AND OBJECTIVE: Rabeprazole sodium is a proton pump inhibitor used for the treatment of gastroesophageal reflux disease (GERD). The objective of this study was to develop a population pharmacokinetic model for rabeprazole that describes concentration-time data arising from phase I and phase III studies in adult and pediatric subjects, including neonates and preterm infants, and propose dosing recommendations for pediatric subjects aged 1-11 years. METHODS: A total of 4,417 pharmacokinetic observations from 597 subjects aged 6 days to 55...
October 2014: Clinical Pharmacokinetics
S Nicole Chadha, Li Wang, Hernan Correa, Dedrick Moulton, Donna S Hummell
BACKGROUND: Eosinophilic esophagitis (EoE) is a chronic allergic disease of the esophagus unresponsive to treatment with proton pump inhibitors. A combination of immediate, IgE-mediated and delayed, and non-IgE-mediated immune reactions to foods and aeroallergens is thought to contribute to disease pathogenesis. Optimal methods to assess for food allergen sensitization have been debated. Patients with EoE often have comorbid atopic diseases. OBJECTIVE: To characterize pediatric patients diagnosed with EoE at a single institution within the southeastern United States...
October 2014: Annals of Allergy, Asthma & Immunology
Rachel van der Pol, Miranda Langendam, Marc Benninga, Michiel van Wijk, Merit Tabbers
IMPORTANCE: Histamine-2 receptor antagonists (H2RAs) are frequently used in the treatment of gastroesophageal reflux disease (GERD) in children; however, their efficacy and safety is questionable. OBJECTIVE: To systematically review the literature to assess the efficacy and safety of H2RAs in pediatric GERD. EVIDENCE REVIEW: PubMed, EMBASE, and the Cochrane database were searched for randomized clinical trials investigating the efficacy and safety of H2RAs in pediatric GERD...
October 2014: JAMA Pediatrics
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