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[Cisapride efficacy in gastroesophageal reflux in children]
11 Clinica Pediatrica, Policlinico di Catania, Università di Catania, Italia.
Insights
Cisapride effectively treated gastroesophageal reflux disease in infants and children. This prokinetic agent improved clinical symptoms and pH monitoring results over an 8-week treatment period.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Motility Disorders
- Pharmacology
Context:
- Gastroesophageal reflux disease (GERD) is increasingly recognized, with motility disorders playing a key role in its pathogenesis.
- Traditional prokinetic agents for GERD have shown mixed results and potential side effects.
- Cisapride, a prokinetic agent enhancing acetylcholine release, emerged as a promising therapeutic option.
Purpose:
- To investigate the efficacy and tolerability of oral cisapride in treating gastroesophageal reflux disease in pediatric patients.
- To evaluate clinical and objective measures of GERD improvement following cisapride administration.
Summary:
- Twelve children (3-40 months) with diagnosed GERD received oral cisapride (1 mg/kg/day) for 8 weeks.
- Diagnosis involved clinical criteria, barium swallow, and 24-hour intraesophageal pH monitoring.
- Treatment outcomes were assessed via clinical evaluation (weight, length, symptom scores) and repeat pH monitoring.
Impact:
- Cisapride demonstrated effectiveness in improving clinical symptoms and objective GERD parameters in pediatric patients.
- The study supports cisapride as a well-tolerated and effective treatment for pediatric GERD.
- Findings contribute to understanding prokinetic agent utility in managing GERD in young children.
Abstract:
In the last years gastroesophageal reflux disease received more attentions, due to an improving in diagnostic techniques. Motility disorders, such as reduced competence of lower esophageal sphincter, motor esophageal disorders, delayed gastric emptying are important factors in the pathogenesis of the disease. Therefore therapy using prokinetic agents has been considered useful. A variety of drugs such as bethanecol, metoclopramide and domperidone have been used. There are conflicting report on the effects of these drugs and it should also be emphasized that they are not devoid of side effects related to dopamine antagonism. Recently cisapride, prokinetic agent which acts through facilitation of acetylcholine release, has been considered effective and well tolerate drug for the treatment of gastroesophageal reflux disease. In this view we investigated the effects of oral administration of cisapride in 12 children (age range 3-40 months), 7 females and 5 males, suffering from gastroesophageal reflux disease diagnosed on the bases of: clinic criteria, barium swallow radiological examination, 24-hour intraesophageal pH monitoring. After diagnosis a treatment with cisapride (1 mg/kg/die) before feedings for 8 weeks was started in all children. At the end of the trial clinical assessment and 24-hour intraesophageal pH test were performed. Clinical assessment was determined through weight, length and a clinical score calculated using the following parameters: regurgitation, vomiting, irritability, nocturnal weeping, meteorism, respiratory complaints. The total score was evaluated at diagnosis and during the follow-up (1st, 2nd, 4th and 8th week).(ABSTRACT TRUNCATED AT 250 WORDS)