Natural History of Infant Reflux Esophagitis: Symptoms and Morphometric Histology During One Year Without Pharmacotherapy
| Autor: | Sheryl F Kelsey, Theresa M. Shalaby, Susan R. Orenstein, Eric A. Frankel |
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| Rok vydání: | 2006 |
| Předmět: |
Male
medicine.medical_specialty Biopsy Remission Spontaneous Histamine Antagonists Observation Gastroenterology Esophagus Pharmacotherapy Internal medicine medicine Humans Receptors Histamine H2 Esophagitis Peptic Life Style Infant Reflux Hepatology medicine.diagnostic_test Esophageal disease business.industry Follow up studies Infant Histology Anti-Ulcer Agents medicine.disease Combined Modality Therapy Natural history Female Gastrointestinal Motility business Esophagitis Follow-Up Studies |
| Zdroj: | The American Journal of Gastroenterology. 101:628-640 |
| ISSN: | 1572-0241 0002-9270 |
| DOI: | 10.1111/j.1572-0241.2006.00442.x |
| Popis: | To determine the natural history of infant gastroesophageal reflux disease (GERD) with esophagitis, we periodically analyzed symptoms and biopsies during 1 yr in 19 infants randomly assigned to placebo in a pharmacotherapy study.One hundred infants who were referred during 1994-1999 for GERD, were unresponsive to 2-wk life-style measures, and manifested morphometric reflux esophagitis, were assigned at random to one of four treatment arms. This analysis examines the 19 (ages 2.8-6.0 months) assigned to placebo who returned for initial follow-up. SYMPTOMS and esophageal biopsy were assessed at baseline and 2, 4, 6, and 12 months. At any visit with both symptoms and biopsy unimproved, infants were "rescued" to open label active drug.By 12 months, 10/19 completed without rescue; the 9 others withdrew (3) or required pharmacotherapy (6).Among the 10 nonrescued completers, parents' global score rated 9 "completely well," and 1 "improved." Comparing 12-month symptoms to baseline symptoms in the 10 completers, fewer reported regurgitation3/day,1 Tbsp, or that was uncomfortable; crying1 h/d, or during or after feeds; or arching spells or abnormal hiccups (p0.05, chi(2)). Biopsy: None of the 10 ever had normal biopsies (basal cell layer25% and papillary height53% of epithelial thickness). One had normal papillary height, but abnormal basal thickness. Five others had normal basal thickness, but all five of them had abnormal papillary height.Although symptoms improved in more than half of the infants with reflux esophagitis followed longitudinally for 1 yr without pharmacotherapy, histology remained abnormal. |
| Databáze: | OpenAIRE |
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