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Effectiveness of sucralfate in preventing esophageal stricture in children after ingestion of caustic agents

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Abstract

Ingestion of caustic agents by children is a serious health issue that can affect the patient for the rest of his life. The role of sucralfate in preventing stricture caused by caustic agents is controversial, and limited studies have been conducted in this field. We aimed to investigate the effect of sucralfate on preventing esophageal stricture in children. Sixty children with mean age of 36.69 ± 20.50 months and grade II B esophageal burns due to ingestion of caustic agents were enrolled in the study. In the intervention group, in addition to the usual treatment, sucralfate was administered orally at a dose of 80 mg/kg every 2 h for 3 days. For the control group, only the usual treatment was prescribed. Stricture development was compared between groups based on endoscopic and radiologic findings. Of the 60 patients enrolled in the study, 53 were examined. The incidence of esophageal stricture in the intervention group was significantly lower than in the control group (37% versus 67%, P-value = 0.042). In addition, the odds of esophageal stricture after sucralfate intervention was significantly reduced after adjustment for potential confounders (OR = 0.198, P-value = 0.031).

  Conclusions: The results of this study showed that sucralfate may reduce the development of esophageal stricture in children when used to manage IIB esophageal burns due to ingestion of caustic agents.

What is Known:

• Ingestion of caustic agents by children is a serious health issue that can affect the patient for the rest of his life.

• The role of sucralfate in preventing stricture caused by caustic agents is controversial and limited studies have been conducted in this field.

What is New:

• It seems that sucralfate significantly reduces the incidence of esophageal stricture following the ingestion of caustic agents in children compared to the control group.

• We believe that the prognosis may be improved and the risk of stricture formation may be reduced with high doses of sucralfate therapy in grade IIB esophageal injury.

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Acknowledgements

This study is taken from the registry program in infants at Tehran University of Medical Sciences. We are thankful to Dr Pejman Rohani, head of the registry at Tehran University of Medical Sciences.

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Authors and Affiliations

  1. Pediatric Gastroenterology and Hepatology Research Center, Pediatrics Centre of Excellence, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran

    Roghayeh Faraji Akhijahani, Fatemeh Farahmand, Parisa Rahmani, Farzaneh Motamed, Kambiz Eftekhari & Mohammad Hassan Sohouli

  2. Postgraduate Programme in Collective Health, Federal University of Maranhão, Rua Barão de Itapary, 155, São Luís - MA, Centro, Brazil

    Elma Izze da Silva Magalhães

  3. Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Mohammad Hassan Sohouli

Authors
  1. Roghayeh Faraji Akhijahani
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  2. Fatemeh Farahmand
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  4. Farzaneh Motamed
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  6. Elma Izze da Silva Magalhães
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  7. Mohammad Hassan Sohouli
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Contributions

R.F. and F.F. contributed in conception, design, and statistical analysis. MH.S., F.F., R.F., P.R., F.M., K.E., and E.S. contributed in data collection and manuscript drafting. MH.S and F.F supervised the study. All authors approved the final version of the manuscript.

Corresponding author

Correspondence to Mohammad Hassan Sohouli.

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Ethics approval and consent to participate

This study was approved by the research council and ethics committee of Tehran University of Medical Sciences, Tehran, Iran. We confirm that all methods were carried out in accordance with relevant guidelines and regulations. Also, we confirm that informed consent was obtained from a parent and/or legal guardians of the participants (control as well as patients).

Competing interests

The authors declare no competing interests.

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Communicated by Peter de Winter

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Akhijahani, R.F., Farahmand, F., Rahmani, P. et al. Effectiveness of sucralfate in preventing esophageal stricture in children after ingestion of caustic agents. Eur J Pediatr 182, 2591–2596 (2023). https://doi.org/10.1007/s00431-023-04924-2

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  • DOI: https://doi.org/10.1007/s00431-023-04924-2

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