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. 1984 Sep;59(9):842–847. doi: 10.1136/adc.59.9.842

Antacids and cimetidine treatment for gastro-oesophageal reflux and peptic oesophagitis.

S Cucchiara, A Staiano, G Romaniello, S Capobianco, S Auricchio
PMCID: PMC1628726  PMID: 6385868

Abstract

Thirty three children aged 2 to 42 months (mean 9 months) with gastro-oesophageal reflux and peptic oesophagitis took part in a treatment trial comparing cimetidine (20 mg/kg/day) with an intensive regimen of antacids (Maalox, 700 mmol (mEq)/1 X 73 m2/day). All children were evaluated clinically and by radiology, acid reflux test, and endoscopy. After 12 weeks of treatment all were again evaluated clinically, by pH measurement, and endoscopy. Twenty nine children, 15 on antacid and 14 on cimetidine, completed the trial. Eight patients on antacid and seven on cimetidine were cured; five on antacid and six on cimetidine improved; and two patients on antacid and one on cimetidine underwent surgery. Both groups of children showed a statistically significant reduction in the score of clinical, pH, and endoscopic variables after treatment. Lower oesophageal sphincter pressure before treatment did not correlate significantly with the final total score. Antacids in large quantities are as effective as cimetidine in medical treatment of gastro-oesophageal reflux and peptic oesophagitis.

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Selected References

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  1. Behar J., Brand D. L., Brown F. C., Castell D. O., Cohen S., Crossley R. J., Pope C. E., 2nd, Winans C. S. Cimetidine in the treatment of symptomatic gastroesophageal reflux: a double blind controlled trial. Gastroenterology. 1978 Feb;74(2 Pt 2):441–448. [PubMed] [Google Scholar]
  2. Behar J., Sheahan D. G., Biancani P., Spiro H. M., Storer E. H. Medical and surgical management of reflux esophagitis. A 38-month report of a prospective clinical trial. N Engl J Med. 1975 Aug 7;293(6):263–268. doi: 10.1056/NEJM197508072930602. [DOI] [PubMed] [Google Scholar]
  3. CARRE I. J. The natural history of the partial thoracic stomach (hiatus hernia) in children. Arch Dis Child. 1959 Aug;34:344–353. doi: 10.1136/adc.34.176.344. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Christie D. L. The acid reflux test for gastroesophageal reflux. J Pediatr. 1979 Jan;94(1):78–81. doi: 10.1016/s0022-3476(79)80360-1. [DOI] [PubMed] [Google Scholar]
  5. Cohen S., Snape W. J., Jr The pathophysiology and treatment of gastroesophageal reflux disease: new concepts. Arch Intern Med. 1978 Sep;138(9):1398–1401. [PubMed] [Google Scholar]
  6. Euler A. R., Ament M. E. Detection of gastroesophageal reflux in the pediatric-age patient by esophageal intraluminal pH probe measurement (Tuttle test). Pediatrics. 1977 Jul;60(1):65–68. [PubMed] [Google Scholar]
  7. Euler A. R., Ament M. E. Gastroesophageal reflux in children: clinical manifestations, diagnosis, pathophysiology, and therapy. Pediatr Ann. 1976 Nov;5(11):678–689. [PubMed] [Google Scholar]
  8. Euler A. R. Use of bethanechol for the treatment of gastroesophageal reflux. J Pediatr. 1980 Feb;96(2):321–324. doi: 10.1016/s0022-3476(80)80839-0. [DOI] [PubMed] [Google Scholar]
  9. Ferguson R., Dronfield M. W., Atkinson M. Cimetidine in treatment of reflux oesophagitis with peptic stricture. Br Med J. 1979 Aug 25;2(6188):472–474. doi: 10.1136/bmj.2.6188.472. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Forget P. P., Meradji M. Contribution of fibreoptic endoscopy to diagnosis and management of children with gastro-oesophageal reflux. Arch Dis Child. 1976 Jan;51(1):60–66. doi: 10.1136/adc.51.1.60. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Graham D. Y., Patterson D. J. Double-blind comparison of liquid antacid and placebo in the treatment of symptomatic reflux esophagitis. Dig Dis Sci. 1983 Jun;28(6):559–563. doi: 10.1007/BF01308159. [DOI] [PubMed] [Google Scholar]
  12. Herbst J. J. Gastroesophageal reflux. J Pediatr. 1981 Jun;98(6):859–870. doi: 10.1016/s0022-3476(81)80576-8. [DOI] [PubMed] [Google Scholar]
  13. Higgs R. H., Smyth R. D., Castell D. O. Gastric alkalinization. Effect on lower-esophageal-sphincter pressure and serum gastrin. N Engl J Med. 1974 Sep 5;291(10):486–490. doi: 10.1056/NEJM197409052911002. [DOI] [PubMed] [Google Scholar]
  14. Johnson D. G., Jolley S. G., Herbst J. J., Cordell L. J. Surgical selection of infants with gastroesophageal reflux. J Pediatr Surg. 1981 Aug;16(4 Suppl 1):587–594. doi: 10.1016/0022-3468(81)90010-5. [DOI] [PubMed] [Google Scholar]
  15. Kestenbaum D., Behar J. Pathogenesis, diagnosis, and management of reflux esophagitis. Annu Rev Med. 1981;32:443–456. doi: 10.1146/annurev.me.32.020181.002303. [DOI] [PubMed] [Google Scholar]
  16. Kobayashi S., Kasugai T. Endoscopic and biopsy criteria for the diagnosis of esophagitis with a fiberoptic esophagoscope. Am J Dig Dis. 1974 Apr;19(4):345–352. doi: 10.1007/BF01072525. [DOI] [PubMed] [Google Scholar]
  17. Moroz S. P., Espinoza J., Cumming W. A., Diamant N. E. Lower esophageal sphincter function in children with and without gastroesophageal reflux. Gastroenterology. 1976 Aug;71(2):236–241. [PubMed] [Google Scholar]
  18. Powell-Jackson P., Barkley H., Northfield T. C. Effect of cimetidine in symptomatic gastro-oesophageal reflux. Lancet. 1978 Nov 18;2(8099):1068–1069. doi: 10.1016/s0140-6736(78)91802-0. [DOI] [PubMed] [Google Scholar]
  19. Saco L. S., Orlando R. C., Levinson S. L., Bozymski E. M., Jones J. D., Frakes J. T. Double-blind controlled trial of bethanechol and antacid versus placebo and antacid in the treatment of erosive esophagitis. Gastroenterology. 1982 Jun;82(6):1369–1373. [PubMed] [Google Scholar]
  20. Sladen G. E., Riddell R. H., Willoughby J. M. Oesophagoscopy, biopsy, and acid perfusion test in diagnosis of "reflux oesophagitis". Br Med J. 1975 Jan 11;1(5949):71–76. doi: 10.1136/bmj.1.5949.71. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Sonnenberg A., Lepsien G., Müller-Lissner S. A., Koelz H. R., Siewert J. R., Blum A. L. When is esophagitis healed? esophageal endoscopy, histology and function before and after cimetidine treatment. Dig Dis Sci. 1982 Apr;27(4):297–302. doi: 10.1007/BF01296747. [DOI] [PubMed] [Google Scholar]
  22. Spencer H., Lender M. Adverse effects of aluminum-containing antacids on mineral metabolism. Gastroenterology. 1979 Mar;76(3):603–606. [PubMed] [Google Scholar]
  23. Strickland A. D., Chang J. H. Results of treatment of gastroesophageal reflux with bethanechol. J Pediatr. 1983 Aug;103(2):311–315. doi: 10.1016/s0022-3476(83)80375-8. [DOI] [PubMed] [Google Scholar]
  24. Thanik K. D., Chey W. Y., Shah A. N., Gutierrez J. G. Reflux esophagitis: effect of oral bethanechol on symptoms and endoscopic findings. Ann Intern Med. 1980 Dec;93(6):805–808. doi: 10.7326/0003-4819-93-6-805. [DOI] [PubMed] [Google Scholar]
  25. Wesdorp E., Bartelsman J., Pape K., Dekker W., Tytgat G. N. Oral cimetidine in reflux esophagitis: a double blind controlled trial. Gastroenterology. 1978 May;74(5 Pt 1):821–824. [PubMed] [Google Scholar]

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