Clinical efficacy of proton pump inhibitor therapy in neurologically impaired children with gastroesophageal reflux: prospective study

KM Cheung, PWT Tse, CH Ko, YC Chan, CY Leung, KH Chan
Department of Paediatrics, Caritas Medical Centre, 111 Wing Hong Street, Shamshuipo, Kowloon, Hong Kong

OBJECTIVE. To study the effects of proton pump inhibitors in reducing vomiting, gastrointestinal bleeding, and chest infections in institutionalized neurologically impaired children with gastroesophageal reflux.

DESIGN. Prospective study.

SETTING. A regional hospital, Hong Kong.

PATIENTS. Neurologically impaired children with refractory gastroesophageal reflux.

MAIN OUTCOME MEASURES. Episodes of vomiting, gastrointestinal bleeding, and pneumonia in the baseline and proton pump inhibitor treatment periods.

RESULTS. Nine children received proton pump inhibitor therapy for a median duration of 81 days. Mean reflux index was 9.3% (standard deviation, 5%). Dosage of omeprazole used was 1.0-2.3 mg/kg/d. Vomiting was reduced significantly with proton pump inhibitor treatment (median vomiting index [baseline]=0.4, median vomiting index [proton pump inhibitors]=0.2; P<0.05). No significant decrease in gastrointestinal bleeding or chest infection was observed.

CONCLUSION. Proton pump inhibitors significantly reduced vomiting episodes in neurologically impaired children with gastroesophageal reflux.

Hong Kong Med J 2001;7:356-9

Key words: Child; Gastroesophageal reflux; Omeprazole; Vomiting