Clonazepam treatment of pathologic aerophagia in children with mental retardation
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Ga-Hyun Lee1, Hyo-Jeong Jang2, Jin-Bok Hwang1
1Department of Pediatrics, Keimyung University School of Medicine, Daegu, Korea.
Insights
Clonazepam showed promise in managing pathologic aerophagia (PA) in children with mental retardation (MR), leading to higher remission rates compared to reassurance alone. This suggests clonazepam as a potential treatment for PA in this vulnerable population.
Area of Science:
- Pediatric Gastroenterology
- Neurodevelopmental Disorders
- Pharmacology
Background:
- Pathologic aerophagia (PA) poses risks such as bowel perforation and volvulus in patients with mental retardation (MR).
- Effective management strategies for PA in children with severe to profound MR are crucial to prevent serious complications.
Purpose of the Study:
- To investigate the efficacy of clonazepam in managing pathologic aerophagia (PA) in children with severe to profound mental retardation (MR).
Main Methods:
- A retrospective case analysis of 21 PA patients with MR was conducted.
- Patients were divided into two groups: clonazepam treatment and reassurance.
- Response and remission rates, along with side effects, were analyzed over a 12-month follow-up period.
Main Results:
- The clonazepam group (n=11) showed a 54.5% remission rate, significantly higher than the reassurance group (n=10) with a 10% remission rate (p=0.040).
- While only 18.2% in the clonazepam group achieved a positive response, the remission rates indicate a notable benefit.
- No significant differences in clinical features were observed between the groups prior to treatment.
Conclusions:
- Clonazepam may be a beneficial treatment option for children with mental retardation experiencing pathologic aerophagia, particularly those with severe bowel distention.
- A trial of clonazepam could be considered before surgical intervention in PA patients with MR to prevent acute abdominal conditions.
Purpose:
Pathologic aerophagia (PA) may lead to bowel perforation or volvulus in mentally retarded patients. The authors investigated the effects of clonazepam on the management of PA in children with severe to profound mental retardation (MR).
Methods:
This study was undertaken as a retrospective case analysis of 21 PA patients with MR who were followed for over 12 months and diagnosed as having PA. Patients were assigned to two management groups, that is, to a clonazepam randomized open-labeled, treatment group or a reassurance group. The following were recorded and analyzed; age, response, remission rate to clonazepam treatment, and the side effect of clonazepam. It was defined positive response (response+) as being symptom-free for a whole week within 1 month of commencing treatment and remission(+) as being symptom-free for a whole month within 6 months of treatment.
Results:
The average age of the 21 PA children with MR was 10 years and 13 patients were female. Symptom duration before diagnosis of PA was 7 months. Clinical features of the clonazepam-trial group (n=11) and the reassurance group (n=10) were non-significantly different. Response(+) was achieved by 2 patients (18.2%) in the clonazepam-trial group and by no patient in the reassurance group. Remission(+) was achieved by 6 patients (54.5%) in the clonazepam-trial group and by one patient (10%) in the reassurance group (p=0.040).
Conclusion:
When PA children with MR with severe bowel distention are considered for surgical treatment to prevent acute abdomen, a trial of clonazepam could be recommended.