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Cisapride decreases prolonged episodes of reflux in infants
Y Vandenplas1, C de Roy, L Sacre
1Academisch Ziekenhuis Kinderen, Vrije Universiteit Brussel, Belgium.
Insights
Cisapride improved gastroesophageal reflux in infants when added to positional therapy. This medication reduced prolonged reflux episodes, suggesting it aids both prevention and esophageal clearance in infants.
Area of Science:
- Pediatrics
- Gastroenterology
- Pharmacology
Background:
- Gastroesophageal reflux is common in infants.
- Positional treatment (prone-anti-Trendelenburg) is effective for infant reflux.
- Pathological gastroesophageal reflux requires effective therapeutic interventions.
Purpose of the Study:
- To evaluate the efficacy of cisapride in treating pathological gastroesophageal reflux in infants.
- To compare cisapride's effect with placebo when added to positional therapy.
- To assess cisapride's impact on reflux episode duration and frequency.
Main Methods:
- A randomized controlled trial involving 29 infants (2-4 months old) with diagnosed pathological gastroesophageal reflux.
- Infants received either cisapride or placebo in addition to positional treatment (prone-anti-Trendelenburg).
- 24-h esophageal pH monitoring was performed before and after 13-16 days of treatment.
Main Results:
- Both cisapride and placebo groups showed general improvement in most pH monitoring parameters.
- The placebo group did not show a significant decrease in prolonged ( >5 min) or total reflux episodes.
- The cisapride group demonstrated a significantly greater reduction in prolonged reflux episodes compared to placebo.
Conclusions:
- Cisapride, in conjunction with positional therapy, may offer significant benefits for infant gastroesophageal reflux disease.
- Cisapride appears to both prevent reflux episodes and enhance esophageal clearance in infants.
- The findings support cisapride as a potential therapeutic agent for managing pathological infant reflux.
Abstract:
Twenty-nine infants (2-4 months old), with pathological gastroesophageal reflux assessed by 24-h esophageal pH monitoring, were studied. Cisapride or placebo was randomly added to positional treatment, prone-antiTrendelenburg position, which was applied to all infants. The pH monitoring was repeated after 13-16 days of treatment and revealed a significant improvement in both groups for most parameters. But the number of reflux episodes lasting longer than 5 min and the total number of reflux episodes had not decreased significantly in the placebo group. Only in the number of reflux episodes lasting longer than 5 min was improvement during treatment significantly greater in the cisapride group. This suggests cisapride both prevented reflux and improved esophageal clearance. These results suggest that in addition to other therapeutic measurements, such as positional treatment (which was previously demonstrated to be effective in this age group), cisapride might be of benefit in the treatment of gastroesophageal reflux disease.