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Omeprazole for severe reflux esophagitis in children
C De Giacomo1, P Bawa, M Franceschi
1Clinica Pediatrica, Università di Pavia, IRCCS Policlinico, S. Matteo, Italy.
Summary
Omeprazole effectively treats severe pediatric esophagitis short-term. A simplified weight-based dosage improved clinical and endoscopic outcomes, though histologic healing and relapse rates require further study.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Motility Disorders
- Pharmacology
Background:
- Severe esophagitis, a rare gastroesophageal reflux complication in children, lacks established treatment guidelines.
- Omeprazole is the standard for severe erosive esophagitis in adults, but pediatric data and optimal dosing remain unclear.
Purpose of the Study:
- To assess the efficacy of a simplified, body-weight-based daily omeprazole dosage for severe pediatric esophagitis.
Main Methods:
- Prospective study of 10 children with severe esophagitis (median age 75.6 months).
- Evaluations included endoscopy, histology, and 24-h pH-metry before and after 3 months of omeprazole treatment.
- Dosage: 20 mg daily for <30 kg, 40 mg daily for >30 kg.
Main Results:
- Significant clinical, endoscopic, and pH-metry improvements observed after 3 months.
- Histologic assessment showed no significant improvement in inflammatory or hyperplastic findings.
- Six out of 10 patients relapsed after therapy discontinuation.
Conclusions:
- Omeprazole demonstrates short-term efficacy for severe pediatric esophagitis.
- Body weight provides a simple basis for daily omeprazole dosing in children.
- Persistent histologic esophagitis despite clinical healing may predict a poorer outcome.