Comparative evaluation of the efficiency of different therapy options for gastroesophageal reflux disease in children

Abstract

Objective: to determine the effective dose and type of proton pump inhibitors in children with varying degrees of gastroesophageal reflux disease (GERD). Subjects and methods. One hundred and fifty-six children aged 9 to 17 years were examined. Therapeutic effectiveness was evaluated from clinical evidence, endoscopic results, and parietal pH-metry data. Group 1 consisted of 52 children who had received a proton pump inhibitor 0,5 mg/kg and a prokinetic; Group 2 included 56 children who had taken only a proton pump inhibitor 1 mg/kg; Group 3 comprised 48 children who had been on triple eradication therapy. In children with grade I GERD, the proton pump inhibitors in doses of 0,5 and 1 mg/kg were effective; however, their lower dosage increased the duration of a therapy cycle. In grade II GERD, the proton pump inhibitors in a dose of 1 mgAg promote the relief of clinical and endoscopic manifestations in shorter periods; preference should be given to esomeprazole. Therapy against Helicobacter pylori has a statistically more significant effect on trends in clinical manifestations and particularly in the endoscopic signs of esophageal injury. The key area in treating the disease in children is to eliminate enhanced gastric acid-producing function with proton pump inhibitors and to prescribe anti-Helicobacter pylori therapy, if indicated.