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Pharmacological Reflux Therapies

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Esophageal and Gastric Disorders in Infancy and Childhood

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Abstract

The management of GERD was revolutionized by the introduction of histamine type 2 receptor antagonists (H2RA) in the 1970s and even more so with the introduction of proton pump inhibitors (PPI) in the 1980s, [1, 2]. The pharmacotherapy for GERD has expanded as our understanding of the mechanisms leading to GERD has advanced from the role of acid to include TLESRs (transient lower esophageal sphincter relaxations) [3, 4] and recognition that nonacid reflux can cause symptoms in some patients. The goals for pharmacotherapy for GERD are to control symptoms, promote gastric and esophageal tissue healing, improve health-related quality of life, prevent complications, and minimize the adverse effects.

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References

  1. Zeldis JB M.D., Ph.D., Friedman LS M.D., Isselbacher KJ M.D. Ranitidine: a new H2-receptor antagonist. N Engl J Med. 1983;309:1368–73.

    Article  CAS  PubMed  Google Scholar 

  2. Allgood PC, Bachmann M. Medical or surgical treatment for chronic gastrooesophageal reflux? A systematic review of published evidence of effectiveness. Eur J Surg. 2000;166(9):713–21.

    Article  CAS  PubMed  Google Scholar 

  3. Kawahara H, Dent J, Davidson G. Mechanisms responsible for gastroesophageal reflux in children. Gastroenterology. 1997;113:399–408.

    Article  CAS  PubMed  Google Scholar 

  4. Omari T. Gastro-oesophageal reflux disease in infants and children: new insights, developments and old chestnuts. J Pediatr Gastroenterol Nutr. 2005;41 Suppl 1:S21–3.

    Article  PubMed  Google Scholar 

  5. Chiba N, De Gara CJ, Wilkinson JM, Hunt RH. Speed of healing and symptom relief in grade II to IV gastroesophageal reflux disease: a meta-analysis. Gastroenterology. 1997;112(6):1798–810.

    Article  CAS  PubMed  Google Scholar 

  6. Cucchiara S, Gobio-Casali L, Balli F, Magazzu G, Staiano A, Astolfi R, Amarri S, Conti-Nibali S, Guandalini S. Cimetidine treatment of reflux esophagitis in children: an Italian multicentric study. J Pediatr Gastroenterol Nutr. 1989;8(2):150–6.

    Article  CAS  PubMed  Google Scholar 

  7. Simeone D, Caria MC, Miele E, Staiano A. Treatment of childhood peptic esophagitis: a double-blind placebo-controlled trial of nizatidine. J Pediatr Gastroenterol Nutr. 1997;25(1):51–5.

    Article  CAS  PubMed  Google Scholar 

  8. Colin-Jones DG. The role and limitations of H2-receptor antagonists in the treatment of gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 1995;9 Suppl 1:9–14.

    PubMed  Google Scholar 

  9. Hassall E. Decisions in diagnosing and managing chronic gastroesophageal reflux disease in children. J Pediatr. 2005;146(3 Suppl):S3–12.

    Article  PubMed  Google Scholar 

  10. Kuo P, Holloway RH. Beyond acid suppression: new pharmacologic approaches for treatment of GERD. Curr Gastroenterol Rep. 2010;12(3):175–80.

    Article  PubMed  Google Scholar 

  11. Vandenplas Y, Rudolph CD, Di Lorenzo C, Hassall E, Liptak G, Mazur L, Sondheimer J, Staiano A, Thomson M, Veereman-Wauters G, Wenzl TG, North American Society for Pediatric Gastroenterology Hepatology and Nutrition, European Society for Pediatric Gastroenterology Hepatology and Nutrition. Pediatric gastroesophageal reflux clinical practice guidelines: joint recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN). J Pediatr Gastroenterol Nutr. 2009;49(4):498–547.

    Article  PubMed  Google Scholar 

  12. Cucchiara S, Staiano A, Romaniello G, Capobianco S, Auricchio S. Antacids and cimetidine treatment for gastro-oesophageal reflux and peptic oesophagitis. Arch Dis Child. 1984;59(9):842.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Arguelles-Martin F, Gonzalez-Fernandez F, Gentles MG. Sucralfate versus cimetidine in the treatment of reflux esophagitis in children. Am J Med. 1989;86(6A):73–6.

    Article  CAS  PubMed  Google Scholar 

  14. Chey WD, Wong BC, Practice Parameters Committee of the American College of Gastroenterology. American College of Gastroenterology guideline on the management of helicobacter pylori infection. Am J Gastroenterol. 2007;102(8):1808–25.

    Article  CAS  PubMed  Google Scholar 

  15. Cengiz N, Uslu Y, Gok F, Anarat A. Acute renal failure after overdose of colloidal bismuth subcitrate. Pediatr Nephrol. 2005;20:1355–8.

    Article  PubMed  Google Scholar 

  16. Inder Mainie MRCP, Radu Tutuian MD, Donald O, Castell MD. Addition of a H2 receptor antagonist to PPI improves acid control and decreases nocturnal acid breakthrough. J Clin Gastroenterol. 2008;42(6):676–9.

    Article  PubMed  Google Scholar 

  17. Vela MF, Tutuian R, Katz PO, Castell DO. Baclofen decreases acid and non-acid post-prandial gastro-oesophageal reflux measured by combined multichannel intraluminal impedance and pH. Aliment Pharmacol Ther. 2003;17(2):243–51.

    Article  CAS  PubMed  Google Scholar 

  18. Khoshoo V, Haydel Jr R. Effect of antireflux treatment on asthma exacerbations in nonatopic children. J Pediatr Gastroenterol Nutr. 2007;44(3):331–5.

    Article  CAS  PubMed  Google Scholar 

  19. Kawai M, Kawahara H, Hirayama S, et al. Effect of baclofen on emesis and 24-hour esophageal pH in neurologically impaired children with gastroesophageal reflux disease. J Pediatr Gastroenterol Nutr. 2004;38:317–23.

    Article  CAS  PubMed  Google Scholar 

  20. Hassall E. Step-up and step-down approaches to treatment of gastroesophageal reflux disease in children. Curr Gastroenterol Rep. 2008;10(3):324–31.

    Article  PubMed  Google Scholar 

  21. Somogyi A, Becker M, Gugler R. Cimetidine pharmacokinetics and dosage requirements in children. Eur J Pediatr. 1985;144(1):72–6.

    Article  CAS  PubMed  Google Scholar 

  22. Orenstein SR, Blumer JL, Faessel HM, McGuire JA, Fung K, Li BU, Lavine JE, Grunow JE, Treem WR, Ciociola AA. Ranitidine, 75 mg, over-the-counter dose: pharmacokinetic and pharmacodynamic effects in children with symptoms of gastro-oesophageal reflux. Aliment Pharmacol Ther. 2002;16(5):899–907.

    Article  CAS  PubMed  Google Scholar 

  23. Sutphen JL, Dillard VL. Effect of ranitidine on twenty-four-hour gastric acidity in infants. J Pediatr. 1989;114:472–4.

    Article  CAS  PubMed  Google Scholar 

  24. Mallet E, Mouterde O, Dubois F, et al. Use of ranitidine in young infants with gastro-oesophageal reflux. Eur J Clin Pharmacol. 1989;36:641–2.

    Article  CAS  PubMed  Google Scholar 

  25. Abdel-Rahman SM, Johnson FK, Manowitz N, Holmes GB, Kearns GL. Single-dose pharmacokinetics of nizatidine (Axid) in children. J Clin Pharmacol. 2002;42(10):1089–96.

    Article  CAS  PubMed  Google Scholar 

  26. Puzovic M, Hardy G. Stability and compatibility of histamine H2-receptor antagonists in parenteral nutrition mixtures. Curr Opin Clin Nutr Metab Care. 2007;10(3):311–7.

    Article  CAS  PubMed  Google Scholar 

  27. Feldman M, Burton ME. Histamine-2 receptor antagonists. Standard therapy for acid-peptic diseases. N Engl J Med. 1990;323:1672.

    Article  CAS  PubMed  Google Scholar 

  28. Reynolds JC. The clinical importance of drug interactions with antiulcer therapy. J Clin Gastroenterol. 1990;12 Suppl 2:S54–63.

    Article  PubMed  Google Scholar 

  29. Orenstein SR, Shalaby TM, Devandry SN, et al. Famotidine for infant gastro-oesophageal reflux: a multi-centre, randomized, placebo-controlled, withdrawal trial. Aliment Pharmacol Ther. 2003;17:1097–107.

    Article  CAS  PubMed  Google Scholar 

  30. Takami N, Yamamoto Y, Matsuo H, Ohtani H, Sawada Y. Agranulocytosis possibly caused by ranitidine in a patient with renal failure. Int J Clin Pharmacol Ther. 2002;40(11):520–3.

    Article  CAS  PubMed  Google Scholar 

  31. Feldman M, Burton ME. Histamine2-receptor antagonists. Standard therapy for acid-peptic diseases. N Engl J Med. 1990;323:1749.

    Article  CAS  PubMed  Google Scholar 

  32. Kumar A. Cimetidine: an immunomodulator. DICP. 1990;24(3):289–95.

    Article  CAS  PubMed  Google Scholar 

  33. Jr. Potter HP, Byrne EB, Lebovitz S. Fever after cimetidine and ranitidine. Clin Gastroenterol. 1986;8(3 Pt 1):275–6.

    Article  Google Scholar 

  34. Jensen RT, Collen MJ, Pandol SJ, et al. Cimetidine-induced impotence and breast changes in patients with gastric hypersecretory states. N Engl J Med. 1983;308:883.

    Article  CAS  PubMed  Google Scholar 

  35. Freston JW. Omeprazole, hypergastrinemia, and gastric carcinoid tumors. Ann Intern Med. 1994;121:232.

    Article  CAS  PubMed  Google Scholar 

  36. Larsson H, Carlsson E, Mattsson H, Lundell L, Sundler F, Sundell G, Wallmark B, Watanabe T, Håkanson R. Plasma gastrin and gastric enterochromaffinlike cell activation and proliferation. Studies with omeprazole and ranitidine in intact and antrectomized rats. Gastroenterology. 1986;90(2):391–9.

    Article  CAS  PubMed  Google Scholar 

  37. Canani RB, Cirillo P, Roggero P, et al. Therapy with gastric acidity inhibitors increases the risk of acute gastroenteritis and community-acquired pneumonia in children. Pediatrics. 2006;117:e817–20.

    Article  PubMed  Google Scholar 

  38. Garcia Rodriguez LA, Ruigomez A, Panes J. Use of acid-suppressing drugs and the risk of bacterial gastroenteritis. Clin Gastroenterol Hepatol. 2007;5:1418–23.

    Article  PubMed  Google Scholar 

  39. Dial S, Delaney JA, Barkun AN, et al. Use of gastric acid-suppressive agents and the risk of community-acquired clostridium difficile-associated disease. JAMA. 2005;294:2989–95.

    Article  CAS  PubMed  Google Scholar 

  40. Guillet R, Stoll BJ, Cotten CM, et al. Association of H2-blocker therapy and higher incidence of necrotizing enterocolitis in very low birth weight infants. Pediatrics. 2006;117:e137–42.

    Article  PubMed  Google Scholar 

  41. Valuck RJ, Ruscin JM. A case-control study on adverse effects: H2 blocker or proton pump inhibitor use and risk of vitamin B12 deficiency in older adults. J Clin Epidemiol. 2004;57:422–8.

    Article  PubMed  Google Scholar 

  42. Furuta S, Kamada E, Suzuki T, Sugimoto T, Kawabata Y, Shinozaki Y, Sano H. Inhibition of drug metabolism in human liver microsomes by nizatidine, cimetidine and omeprazole. Xenobiotica. 2001;31:1–10.

    Article  CAS  PubMed  Google Scholar 

  43. Hyman PE, Garvey 3rd TQ, Abrams CE. Tolerance to intravenous ranitidine. J Pediatr. 1987;110:794–6.

    Article  CAS  PubMed  Google Scholar 

  44. Nwokolo CU, Smith JT, Gavey C, et al. Tolerance during 29 days of conventional dosing with cimetidine, nizatidine, famotidine or ranitidine. Aliment Pharmacol Ther. 1990;4 Suppl 1:S29–45.

    Google Scholar 

  45. Wilder-Smith CH, Ernst T, Gennoni M, Zeyen B, Halter F, Merki HS. Tolerance to oral H2-receptor antagonists. Dig Dis Sci. 1990;35(8):976–83.

    Article  CAS  PubMed  Google Scholar 

  46. Aslam N, Wright R, Dexlansoprazole NR. Expert Opin Pharmacother. 2009;10(14):2329–36.

    Article  CAS  PubMed  Google Scholar 

  47. Litalien C, Theoret Y, Faure C. Pharmacokinetics of proton pump inhibitors in children. Clin Pharmacokinet. 2005;44:441–66.

    Article  CAS  PubMed  Google Scholar 

  48. Savarino V, Di Mario F, Scarpignato C. Proton pump inhibitors in GORD- an overview of their pharmacology, efficacy and safety. Pharmacol Res. 2009;59:135–53.

    Article  CAS  PubMed  Google Scholar 

  49. Sachs G, Shin JM, Briving C, Wallmark B, Hersey S. The pharmacology of the gastric acid pump: the H+, K+ ATPase. Annu Rev Pharmacol Toxicol. 1995;35:277–305.

    Article  CAS  PubMed  Google Scholar 

  50. Im WB, Blakeman DP, Davis JP. Irreversible inactivation of rat gastric H+, K+ ATPase in vivo by omeprazole. Biochem Biophys Res Commun. 1985;126:78–82.

    Article  CAS  PubMed  Google Scholar 

  51. Shi S, Klotz U. Proton pump inhibitors, an update of their clinical use and pharmacokinetics. Eur J Clin Pharmacol. 2008;64:935–51.

    Article  CAS  PubMed  Google Scholar 

  52. Lind T, Cederberg C, Ekenved G, Haglund U, Olbe L. Effect of omeprazole- a gastric proton pump inhibitor on pentagastrin stimulated acid secretion in man. Gut. 198;24:270–6.

    Google Scholar 

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Author information

Authors and Affiliations

  1. Kennedy Krieger Institute, 707 N Broadway Suite 226, Baltimore, MD, 21205, USA

    Anil Darbari MD

  2. Division of Pediatric Gastroenterology, 600 N Wolfe Streeet, Baltimore, MD, 21205, USA

    Anil Darbari MD

  3. Children’s National Medical Center, 111 Michigan Avenue, NW, Washington, DC, 20010, USA

    Sona Sehgal MD & Nidhi Rawal MD

  4. Administrative Services Coordinator I, Pediatric GI and Feeding Disorders Programme, Kenney Krieger Institute, Baltimore, MA, USA

    Rachel Imhoff

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  1. Anil Darbari MD
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  2. Sona Sehgal MD
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  3. Nidhi Rawal MD
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  4. Rachel Imhoff
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Corresponding author

Correspondence to Anil Darbari MD .

Editor information

Editors and Affiliations

  1. Medical University of Graz, Graz, Austria

    Holger Till

  2. Sheffield Children’s Hospital, Paediatric Gastroenterology Centre, Sheffield, United Kingdom

    Mike Thomson

  3. Division of Cardiothoracic Surgery, Department of Surgery, University of Minnesota Medical School, Minneapolis, Minnesota, USA

    John E. Foker

  4. Department Surgery, University of Missouri, Kansas City Children’s Mercy Hospital, Kansas City, Missouri, USA

    George W. Holcomb III

  5. University of Arizona, Tucson, Arizona, USA

    Khalid M. Khan

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Darbari, A., Sehgal, S., Rawal, N., Imhoff, R. (2017). Pharmacological Reflux Therapies. In: Till, H., Thomson, M., Foker, J., Holcomb III, G., Khan, K. (eds) Esophageal and Gastric Disorders in Infancy and Childhood. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-11202-7_85

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  • DOI: https://doi.org/10.1007/978-3-642-11202-7_85

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