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Are we overprescribing antireflux medications for infants with regurgitation?

Vikram Khoshoo1, Dean Edell, Aaron Thompson

  • 1Pediatric Specialty Center, West Jefferson Medical Center, New Orleans, Louisiana, USA. vkhoshoo@sbcglobal.net

Pediatrics
|November 3, 2007
PubMed

Insights

Most infants with persistent regurgitation prescribed acid reflux medication did not have gastroesophageal reflux disease (GERD). Discontinuing medication was often safe for infants with normal pH monitoring results.

Area of Science:

  • Pediatric Gastroenterology
  • Infant Health
  • Gastrointestinal Disorders

Background:

  • Persistent regurgitation is a common concern in infants.
  • Referral to pediatric gastroenterology services often involves evaluation for gastroesophageal reflux disease (GERD).

Purpose of the Study:

  • To evaluate the diagnostic process and treatment strategies for infants with persistent regurgitation.
  • To assess the appropriateness of antireflux medication use in this population.

Main Methods:

  • Retrospective review of 64 infants with persistent regurgitation.
  • Analysis of diagnostic workup, including extended esophageal pH monitoring in 44 infants.
  • Evaluation of treatment outcomes, including medication discontinuation.

Main Results:

  • Only 8 of 44 (18%) infants showed abnormal acid reflux on pH monitoring.
  • 42 of 44 infants were already on antireflux medications.
  • Discontinuation of medication did not worsen symptoms in most infants with normal pH studies.

Conclusions:

  • The majority of infants referred for persistent regurgitation do not meet diagnostic criteria for GERD.
  • Antireflux medication is frequently prescribed without clear evidence of GERD.
  • Conservative management and careful diagnostic evaluation are crucial.
Abstract

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