CISAPRIDE AND RANITIDINE FOR THE TREATMENT OF
GASTROESOPHAGEAL REFLUX DISEASE IN CHILDREN
Yuce A, Demir H, Ozen H, Gurakan F,
Saltik IN, Kocak N
Pediatric
Gastroenterology Department, Hacettepe University, Ankara, Turkdy
Objective:
Gastroesophageal reflux (GER) may cause various clinical symptoms in
childhood. The treatment options include position, feeding regulations,
gastric acid suppression, prokinetic agents, and surgery in selected
patients. The aim of this study is to evaluate the efficiency of cisapride
plus ranitidine treatment in gastroesophageal reflux.
Methods: Thirty-one
patients, aged 2 months-14 years, were included in the study. Diagnosis was
established by barium swallow, scintigraphy or 24-h esophageal pH
monitoring. All were prescribed cisapride (0.8-1 mg/kg/day, po) plus
ranitidine (4 mg/kg/day). They were evaluated at the end of therapy
regarding symptoms and pH monitoring.
Results: The mean
duration of symptoms was 6.8±4.3 months.
Presenting symptoms were vomiting in 22 patients (71%), chronic cough in 10
(32.3%), wheezing in 9 (29%), recurrent pneumonia in 7 (22.6%), failure to
thrive in 5 (16.1%), epigastric pain in 5 (16.1%), and regurgitation in 1
(6.5%). The patients were followed 2-18 months. Control pH monitoring
revealed no GER in 22 (71%) patients. Symptoms disappeared in 86.4% of the
patients whose control pH monitoring was normal whereas this ratio was
66.7% in those whose pH monitoring was abnormal. The severity of symptoms
decreased in all symptomatic patients regardless of the pH-monitoring
results. All patients tolerated the therapy without side effects.
Conclusions: Cisapride plus ranitidine treatment
is effective in children with GER. The severity of symptoms decreases even
if the patients continue to have GER at esophageal pH-monitoring study.