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Gaviscon and Carobel compared with cisapride in gastro-oesophageal reflux
P Greally1, F J Hampton, U M MacFadyen
1Department of Child Health, Leicester Royal Infirmary.
Insights
Gaviscon plus Carobel was more effective than cisapride for treating gastroesophageal reflux (GER) in infants. Parental evaluations and diary scores favored the Gaviscon/Carobel group, indicating better outcomes for infant reflux management.
Area of Science:
- Pediatric Gastroenterology
- Pharmacology
Background:
- Gastroesophageal reflux (GER) is common in infants.
- Current treatments include prokinetic agents and alginate-based therapies.
Purpose of the Study:
- To compare the efficacy of cisapride with Gaviscon plus Carobel for infant GER treatment.
- To evaluate parental assessments, symptom diaries, and esophageal pH monitoring.
Main Methods:
- A randomized, parallel group study involving 50 infants with confirmed GER.
- Infants received either oral cisapride or Gaviscon plus Carobel for one month.
- Outcomes were assessed via parental evaluations, diary scores, and 24-hour lower esophageal pH recordings.
Main Results:
- 79% of infants on Gaviscon/Carobel improved compared to 53% on cisapride, based on parental evaluation.
- Diary scores showed greater improvement in the Gaviscon/Carobel group.
- More pH variables improved significantly in the Gaviscon/Carobel group, though overall group differences were not significant.
Conclusions:
- Gaviscon plus Carobel demonstrated comparable or superior efficacy to cisapride as a first-line treatment for infant GER.
- Conventional treatment with Gaviscon plus Carobel is a viable alternative to cisapride for managing infant GER.
Abstract:
We compared the efficacy of the prokinetic agent cisapride with that of Gaviscon (an alginate/alkaline compound) plus Carobel (carob seed flour) in the treatment of gastrooesophageal reflux (GOR). Fifty infants with confirmed GOR received either oral cisapride (0.8 mg/kg/day) or Gaviscon plus Carobel for one month in a randomised, parallel group study. Parental evaluations, diary scores, and 24 hour lower oesophageal pH recordings before and at the end of each treatment were compared. In the cisapride group 14/26 (53%) were considered better by their parents compared with 19/24 (79%) of those who received Gaviscon plus Carobel. Diary scores, range (0.00-1.00), improved in both groups with the median change being greater in the Gaviscon plus Carobel group (-0.21) than the cisapride group (-0.15). Five of 17 pH variables had significantly improved from baseline in infants who had received cisapride compared with 11/17 in those receiving Gaviscon plus Carobel. However, unpaired analysis of diary and pH data showed no significant differences between the two groups. We conclude that first line treatment of GOR with cisapride is no more effective than conventional treatment with Gaviscon plus Carobel.