Abstract
We compared the efficacy of the prokinetic agent cisapride with that of Gaviscon (an alginate/alkaline compound) plus Carobel (carob seed flour) in the treatment of gastrooesophageal reflux (GOR). Fifty infants with confirmed GOR received either oral cisapride (0.8 mg/kg/day) or Gaviscon plus Carobel for one month in a randomised, parallel group study. Parental evaluations, diary scores, and 24 hour lower oesophageal pH recordings before and at the end of each treatment were compared. In the cisapride group 14/26 (53%) were considered better by their parents compared with 19/24 (79%) of those who received Gaviscon plus Carobel. Diary scores, range (0.00-1.00), improved in both groups with the median change being greater in the Gaviscon plus Carobel group (-0.21) than the cisapride group (-0.15). Five of 17 pH variables had significantly improved from baseline in infants who had received cisapride compared with 11/17 in those receiving Gaviscon plus Carobel. However, unpaired analysis of diary and pH data showed no significant differences between the two groups. We conclude that first line treatment of GOR with cisapride is no more effective than conventional treatment with Gaviscon plus Carobel.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Baer M., Mäki M., Nurminen J., Turjanmaa V., Pukander J., Vesikari T. Esophagitis and findings of long-term esophageal pH recording in children with repeated lower respiratory tract symptoms. J Pediatr Gastroenterol Nutr. 1986 Mar-Apr;5(2):187–190. [PubMed] [Google Scholar]
- Bailey D. J., Andres J. M., Danek G. D., Pineiro-Carrero V. M. Lack of efficacy of thickened feeding as treatment for gastroesophageal reflux. J Pediatr. 1987 Feb;110(2):187–189. doi: 10.1016/s0022-3476(87)80151-8. [DOI] [PubMed] [Google Scholar]
- Berquist W. E., Ament M. E. Upper GI function in sleeping infants. Am Rev Respir Dis. 1985 May;131(5):S26–S29. doi: 10.1164/arrd.1985.131.S5.S26. [DOI] [PubMed] [Google Scholar]
- Buts J. P., Barudi C., Otte J. B. Double-blind controlled study on the efficacy of sodium alginate (Gaviscon) in reducing gastroesophageal reflux assessed by 24 h continuous pH monitoring in infants and children. Eur J Pediatr. 1987 Mar;146(2):156–158. doi: 10.1007/BF02343223. [DOI] [PubMed] [Google Scholar]
- 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]
- Colson D. J., Campbell C. A., Wright V. A., Watson B. W. Predictive value of oesophageal pH variables in children with gastro-oesophageal reflux. Gut. 1990 Apr;31(4):370–373. doi: 10.1136/gut.31.4.370. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cucchiara S., Staiano A., Boccieri A., De Stefano M., Capozzi C., Manzi G., Camerlingo F., Paone F. M. Effects of cisapride on parameters of oesophageal motility and on the prolonged intraoesophageal pH test in infants with gastro-oesophageal reflux disease. Gut. 1990 Jan;31(1):21–25. doi: 10.1136/gut.31.1.21. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cucchiara S., Staiano A., Capozzi C., Di Lorenzo C., Boccieri A., Auricchio S. Cisapride for gastro-oesophageal reflux and peptic oesophagitis. Arch Dis Child. 1987 May;62(5):454–457. doi: 10.1136/adc.62.5.454. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cucchiara S., Staiano A., Di Lorenzo C., D'Ambrosio R., Andreotti M. R., Prato M., De Filippo P., Auricchio S. Esophageal motor abnormalities in children with gastroesophageal reflux and peptic esophagitis. J Pediatr. 1986 Jun;108(6):907–910. doi: 10.1016/s0022-3476(86)80925-8. [DOI] [PubMed] [Google Scholar]
- Darling D. B., Fisher J. H., Gellis S. S. Hiatal hernia and gastroesophageal reflux in infants and children: analysis of the incidence in North American children. Pediatrics. 1974 Oct;54(4):450–455. [PubMed] [Google Scholar]
- Dent J., Holloway R. H., Toouli J., Dodds W. J. Mechanisms of lower oesophageal sphincter incompetence in patients with symptomatic gastrooesophageal reflux. Gut. 1988 Aug;29(8):1020–1028. doi: 10.1136/gut.29.8.1020. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hampton F. J., MacFadyen U. M., Simpson H. Reproducibility of 24 hour oesophageal pH studies in infants. Arch Dis Child. 1990 Nov;65(11):1249–1254. doi: 10.1136/adc.65.11.1249. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Holloway R. H., Hongo M., Berger K., McCallum R. W. Gastric distention: a mechanism for postprandial gastroesophageal reflux. Gastroenterology. 1985 Oct;89(4):779–784. doi: 10.1016/0016-5085(85)90572-4. [DOI] [PubMed] [Google Scholar]
- Jian R., Ducrot F., Piedeloup C., Mary J. Y., Najean Y., Bernier J. J. Measurement of gastric emptying in dyspeptic patients: effect of a new gastrokinetic agent (cisapride). Gut. 1985 Apr;26(4):352–358. doi: 10.1136/gut.26.4.352. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Laitinen S., Ståhlberg M., Kairaluoma M. I., Kiviniemi H., Päkkönen M., Lahtinen J., Poikolainen E., Aukee S. Sucralfate and alginate/antacid in reflux esophagitis. Scand J Gastroenterol. 1985 Mar;20(2):229–232. doi: 10.3109/00365528509089662. [DOI] [PubMed] [Google Scholar]
- Paton J. Y., Nanayakkhara C. S., Simpson H. Vomiting and gastro-oesophageal reflux. Arch Dis Child. 1988 Jul;63(7):837–838. doi: 10.1136/adc.63.7.837. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Schuurkes J. A., Van Nueten J. M., Van Daele P. G., Reyntjens A. J., Janssen P. A. Motor-stimulating properties of cisapride on isolated gastrointestinal preparations of the guinea pig. J Pharmacol Exp Ther. 1985 Sep;234(3):775–783. [PubMed] [Google Scholar]
- Sondheimer J. M. Gastroesophageal reflux: update on pathogenesis and diagnosis. Pediatr Clin North Am. 1988 Feb;35(1):103–116. doi: 10.1016/s0031-3955(16)36402-1. [DOI] [PubMed] [Google Scholar]
- Stanciu C., Bennett J. R. Alginate-antacid in the reduction of gastro-oesophageal reflux. Lancet. 1974 Jan 26;1(7848):109–111. doi: 10.1016/s0140-6736(74)92340-x. [DOI] [PubMed] [Google Scholar]
- Strobel C. T., Byrne W. J., Ament M. E., Euler A. R. Correlation of esophageal lengths in children with height: application to the Tuttle test without prior esophageal manometry. J Pediatr. 1979 Jan;94(1):81–84. doi: 10.1016/s0022-3476(79)80361-3. [DOI] [PubMed] [Google Scholar]
- Vandenplas Y., Helven R., Goyvaerts H., Sacré L. Reproducibility of continuous 24 hour oesophageal pH monitoring in infants and children. Gut. 1990 Apr;31(4):374–377. doi: 10.1136/gut.31.4.374. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Vandenplas Y., Sacré-Smits L. Gastro-oesophageal reflux in infants. Evaluation of treatment by pH monitoring. Eur J Pediatr. 1987 Sep;146(5):504–507. doi: 10.1007/BF00441604. [DOI] [PubMed] [Google Scholar]
- Washington N., Greaves J. L., Wilson C. G. Effect of time of dosing relative to a meal on the raft formation of an anti-reflux agent. J Pharm Pharmacol. 1990 Jan;42(1):50–53. doi: 10.1111/j.2042-7158.1990.tb05348.x. [DOI] [PubMed] [Google Scholar]