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E Hassall1

  • 1Division of Pediatric Gastroenterology, BC Children's Hospital/University of British Columbia, 4480 Oak St, Vancouver, BC V6H 3V4, Canada. ehassall@cw.bc.ca

Archives of Disease in Childhood
|September 24, 2005
PubMed

Insights

Antireflux surgery for children with gastro-oesophageal reflux disease has questionable outcomes. Proton pump inhibitors (PPIs) offer a safe and effective alternative, often before surgery is considered.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Pharmacology

Background:

  • Antireflux surgery has been a long-standing treatment for pediatric gastro-oesophageal reflux disease (GERD).
  • Despite its history, surgical outcomes are often poor, and highly effective medical alternatives exist.

Purpose of the Study:

  • To evaluate the efficacy and safety of antireflux surgery versus proton pump inhibitors (PPIs) in pediatric GERD.
  • To assess the necessity of surgery when patients have not failed optimized medical management.

Main Methods:

  • Review of existing literature on antireflux surgery and PPIs in children.
  • Analysis of studies reporting objective postoperative testing and treatment outcomes.

Main Results:

  • Many children undergo surgery without confirmed reflux as the cause of symptoms or documented failure of medical therapy.
  • Postoperative objective testing reveals high failure rates for antireflux surgery within 1-3 years.
  • Proton pump inhibitors (PPIs) demonstrate effectiveness and safety as an alternative to surgery.

Conclusions:

  • Antireflux surgery in children may be overutilized, with suboptimal outcomes.
  • PPIs represent a safe and effective first-line treatment option for pediatric GERD, potentially avoiding surgery.

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