Step-up and step-down approaches to treatment of gastroesophageal reflux disease in children
| Autor: | Eric Hassall |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Antireflux surgery
medicine.medical_specialty business.industry Gastroenterology Reflux MEDLINE Diagnostic test Proton Pump Inhibitors General Medicine Disease medicine.disease digestive system diseases Histamine H2 Antagonists Internal medicine Gastroesophageal Reflux medicine GERD Humans Reflux esophagitis Medical prescription Child business Intensive care medicine |
| Zdroj: | Current Gastroenterology Reports. 10:324-331 |
| ISSN: | 1534-312X 1522-8037 |
| Popis: | The single biggest change in the approach to treating pediatric gastroesophageal reflux disease (GERD) in recent years has been the empiric use of proton pump inhibitors (PPIs) for symptoms suspected to be those of GERD. In other words, PPIs have been used increasingly as a first-line concurrent diagnostic test and treatment before any investigation. Although this approach is useful for some patients, there are a number of caveats about its application to children. In general, these caveats are related to age per se (eg, infancy) and to age-related symptoms and severity of GERD itself. The most important caveats relate to the prescription of empiric PPI therapy in infants--which generally is to be avoided--and to how PPIs are used in older children--specifically, the advisability of empiric trials being of limited duration. Even in children with proven reflux esophagitis, GERD is not chronic and relapsing in all; thus, trials of therapy withdrawal are warranted. In light of many factors, including the burgeoning literature on potential risks of infections in acid-suppressed children and adults, caution with dose and duration of acid-suppressive drugs in children is urged. The role of antireflux surgery is also mentioned. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink