Suraj Gupte¹*, Novy Gupte² and Sushmita Patil³

¹Professor and Head (Emeritus), Postgraduate Department of Pediatrics, MMC and Hospitals, Khammam, India
²Assistant Professor, Department of Pharmacology, Army College of Medical Sciences, New Delhi, India
³Consulting Pediatrician, Wadia Hospital, Mumbai, India

*Corresponding Author: Suraj Gupte, Professor and Head (Emeritus), Postgraduate Department of Pediatrics, MMC and Hospitals, Khammam, India.

Received: March 07, 2022; Published: March 14, 2022

Abstract

Background: Gastroesophageal reflux disease (GERD), once a domain of adults only, is now being frequently diagnosed beyond first year of life. However, therapeutic approach to its pharmacological management remains debatable.

Objective: Putting into perspectives the current concepts with our own observations in the drug therapy of GERD in pediatric practice.

Design: Review of recent English medical literature with authors’ own experience in the field.

Salient Features: High index of suspicion followed by a therapeutic trial employing an anti-reflux should precede diagnostic test(s) as and when indicated. H₂ receptor antagonists, preferably ranitidine, should be the drug of first choice in children. A prokintic, preferably metoclopramide, is helpful in cases where abdominal distention and bloating are predominant. The more potent H2 receptor antagonist, cisapride as also the proton pump inhibitors should be reserved for difficult cases not responding to aforesaid approach.

Conclusions: First line treatment of pediatric GERD largely revolves around ranitidine, a H2 antagonist. Metoclopramide, a prokinetic, is helpful as an add-on in case of predominant bloating and abdominal distention. Proton pump inhibitors are now picking up as the preferred choice.

Keywords: Gastroesophageal Reflux Disease (GERD); H2 Receptor Antagonists; Metaclopramide; Omeprazole; Pantaprozole; Prokinetics; Proton-Pump Inhibitors (PPIs); Ranitidine

References

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2. American Academy of Otolaryngology, Head and Neck Surgery. “Pediatric GERD: (Gastroesophageal reflux disease)”.
3. Ruigómez A., et al. “Gastroesophageal reflux disease in children and adolescents in primary care”. Scandinavian Journal of Gastroenterology 45 (2010): 139-146.
4. Kale P and Tiwari S. “Gastroesophageal reflux disease”. In: Gupte S (Ed): Recent Advances in Pediatrics (Specal Vol 23: Pediatric Gastroenterology, Hepatology and Nutrition). New Delhi: Jaypee (2013).
5. Gupte S. “Guest lecture: GERD in children: Two decades’ experience in therapeutics”. Asian-Oceanian Workshop on Pediatric Gastroenterology, Hepatology and Nutrition, Bangkok (2019).
6. Mohan N., et al. “Pediatric Gastroenterology Chapter of Indian Academy of Pediatrics, Indian Society of Pediatric Gastroenterology, Hepatology and Nutrition)”. Indian Pediatrics 28 (2022): 202-228.
7. Gupte S. “Expert Opinion: Pharmacotherapy of Pediatric GERD”. In: GERD Dialogue. New Delhi: Health Knowledge Source (2018).
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Citation

Citation: Suraj Gupte., et al. “Pharmacotherapy of Gastroesophageal Reflux Disease in Children". Acta Scientific Gastrointestinal Disorders 5.4 (2022): 31-34.

Copyright

Copyright: © 2022 Suraj Gupte., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.