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GERD Treatment in Infants: “Friend or Foe”

August 26, 2014 7:00 am

From a recent JAMA Peds editorial: (JAMA Pediatr. Published online August 18, 2014. doi:10.1001/jamapediatrics.2014.1263)

An excerpt:

Gastroesophageal reflux disease (GERD) is common in infants and children and has been estimated to affect as much as 3.3% of the pediatric population.¹ Despite this, we still struggle with the management of GERD. With a growing body of literature that illustrates a lack of efficacy and alarming adverse effects, there is increasing reason to limit the empirical use of acid suppression therapy in children.

Other points highlighted in this editorial:

• 36% of pediatricians prescribe PPIs for infants with uncomplicated regurgitation -“despite evidence and recommendations against this approach.”
• 39% of pediatricians prescribed proton pump inhibitors (PPIs) for infants with unexplained crying
• Conditions predisposing a child for severe GERD include those with neurological impairment, repaired esophageal atresia, cystic fibrosis, hiatal hernia, repaired achalasia, and lung transplantation.
• In the related article ((JAMA Pediatr. doi: 10.10001/jamapediatrics.2014.1273), the authors reviewed 8 studies of histamine-2 receptor antagonists (H2RAs) and noted no improvement in overall symptoms infants.  In older age groups, H2RAs were more effective than placebo in symptom reduction, and histological healing.

Take-home message: “It is becoming clearer that in many circumstances, prescribing acid-reducing medication to infants is doing no good and increasing the risk of harm.”

Related blog posts:

• Will This Change ALTE-GERD Practice? | gutsandgrowth
• “If You Never Give Up, You Cannot Possibly Lose …
• Do medicines work for GERD infants? | gutsandgrowth
• PPIs in Neonates -Helpful? | gutsandgrowth
• ‘Little’ Knowledge Exists Regarding Medicines for …

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Categories: Pediatric Gastroenterology Intestinal Disorder

Tags: Gastroesophageal Reflux, GERD, infant

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3 Responses to “GERD Treatment in Infants: “Friend or Foe””

1. […] GERD Treatment in Infants: “Friend or Foe” | gutsandgrowth […]

   By No Effect of Proton Pump Inhibitors and Irritability on Crying in Infants | gutsandgrowth on April 14, 2015 at 7:01 am

2. […] GERD Treatment in Infants: “Friend or Foe” | gutsandgrowth […]

   By The Prosecution Rests…PPIs on Trial | gutsandgrowth on January 12, 2016 at 7:00 am

3. […] GERD Treatment in Infants: “Friend or Foe” | gutsandgrowth […]

   By Two for the PPI Team | gutsandgrowth on May 9, 2017 at 7:01 am

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