title: The use of H2-receptor antagonist in the treatment of peptic ulcer disease in children.
abstract: We report our 20 years' experience on the management of 78 children with primary chronic peptic ulcer, giving special emphasis to the recent 32 patients (29 duodenal ulcer, 3 gastric ulcer) who received H2-antagonist therapy guided by endoscopic surveillance. The most striking observation was the marked decrease in the incidence of "failed medical treatment necessitating surgery" from 34.8% (16/46) in the pre-H2-antagonist era to 3.1% (1/32) in the H2-antagonist era. H2 antagonist was uniformly well tolerated and without side-effects. In 29 patients with duodenal ulcer, a 6-week therapeutic course resulted in complete ulcer healing in 22 (75.9%). Further therapeutic courses resulted in complete ulcer healing in four additional patients (13.8%). There was only partial ulcer healing in two patients (6.9%) and nonhealing in one patient (3.49%). There were 11 episodes of recurrence in nine patients (symptomatic 5, asymptomatic 6). Recurrence was more frequent when nocturnal-dose maintenance was not given (8/11 recurrences). All recurrences responded satisfactorily to further H2-antagonist therapy. Patients with gastric ulcer responded even more favorably, all three healing completely with a single therapeutic course and not requiring maintenance therapy. We conclude that H2-antagonist is safe and highly effective for healing peptic ulcer in children. For duodenal ulcer, maintenance therapy ensures a satisfactory remission rate.
authors.affiliation: Department of Child Health, Royal Liverpool Children's Hospital Alder Hey, England.
authors.forename: P K
authors.initials: PK
authors.lastname: Tam
authors.forename: H
authors.initials: H
authors.lastname: Saing
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004381:Duodenal Ulcer / Q000188:drug therapy / Q000503:physiopathology; D005260:Female; D005744:Gastric Acid / Q000378:metabolism; D006635:Histamine H2 Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D010437:Peptic Ulcer / Q000188:drug therapy* / Q000503:physiopathology; D012008:Recurrence
chemical_list: D006635:Histamine H2 Antagonists