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Smectite reduces gastroesophageal reflux in newborn infants
J B Gouyon1, V Boggio, M Fantino
1Department of Pediatrics, Faculté de Médecine, Dijon, France.
Insights
Smectite, a natural clay, significantly reduced acid and very acid gastroesophageal reflux (GER) in infants when combined with postural therapy. This treatment improved reflux frequency, duration, and severity, offering a potential therapeutic option.
Area of Science:
- Gastroenterology
- Pediatric Medicine
- Pharmacology
Background:
- Gastroesophageal reflux (GER) is common in infants.
- Pathological GER requires effective management strategies.
- Continuous pH recording (CPR) is a key diagnostic tool.
Purpose of the Study:
- To evaluate the efficacy of smectite in reducing acid and very acid GER in infants.
- To compare smectite combined with postural therapy versus postural therapy alone.
- To assess the impact on GER frequency, duration, and severity.
Main Methods:
- A double-blind, placebo-controlled study involving 20 newborn infants with pathological GER.
- Infants were placed in an elevated prone position and received either smectite (3 g/day) or placebo for 7 days.
- 24-hour continuous pH recording (CPR) was performed before and after treatment.
Main Results:
- Postural therapy alone significantly decreased the number of acid GER events.
- Smectite combined with postural therapy led to significant reductions in acid and very acid GER.
- The combination treatment also decreased the percentage of time spent at pH < 4 and pH < 3, and the maximal GER duration.
Conclusions:
- Smectite, in conjunction with postural therapy, is an effective treatment for reducing acid and very acid gastroesophageal reflux in infants.
- This combination therapy offers significant improvements in GER parameters compared to postural therapy alone.
- Smectite represents a promising therapeutic agent for managing infant GER.
Abstract:
We assessed the efficacy of a natural clay (smectite) on the frequency and the duration of acid (pH less than 4) and very acid (pH less than 3) gastroesophageal reflux (GER) measured by 24-hour continuous pH recording (CPR). Twenty newborn infants were enrolled in this double-blind controlled study owing to pathological CPR in supine position. After inclusion, all the patients were maintained in the 30-degree elevated prone position and received either smectite (3 g/day; n = 10) or placebo (n = 10) for 7 days. On the 8th day, a second 24-hour CPR was performed in supine position. The postural therapy alone (placebo group) was followed by a significant decrease in the numbers of acid GER (p less than 0.05) during the second CPR. The combination of postural therapy and smectite treatment was followed by a decrease in the number of acid (p less than 0.05) and very acid GER (p = 0.01), the percentages of time spent at pH below 4 (p less than 0.05) and 3 (p less than 0.01) and the maximal duration of acid GER (p less than 0.05).