title: Cimetidine treatment of reflux esophagitis in children: an Italian multicentric study.
abstract: The effectiveness of cimetidine (30-40 mg/kg/day) was evaluated in 32 children with gastroesophageal reflux disease complicated by esophagitis who entered a random double-blind trial for 12 weeks. Esophagitis was diagnosed in all patients by endoscopy with biopsy. Seventeen patients (age, mean +/- SD: 21.7 +/- 37.65 months) received cimetidine (c-pts), and 15 (age, mean +/- SD: 29.03 +/- 39.73 months) received a placebo (p-pts). All patients received intensive postural therapy. Based on clinical and endoscopic (and histologic) data, 12 c-pts and three p-pts were healed (p less than 0.01), the condition of four c-pts and three p-pts had improved (not statistically significant), and the condition of one c-pt and nine p-pts had worsened (p less than 0.01). Both clinical and esophagitis scores significantly decreased only in the c-pt group, as compared with p-pts. Improvement of esophagitis was seen in all (100%) of c-pts with mild or moderate esophagitis versus 57.14% of p-pts (p less than 0.01) and in 87.5% of c-pts with severe esophagitis as compared with 25% of the p-pt group (p less than 0.01). We conclude that cimetidine is an effective agent for treatment of reflux esophagitis in children. Although gastroesophageal reflux disease in infancy has a naturally self-limited course with conservative care (thickened feedings and posture adjustment), extensive pharmacologic therapy is needed in the presence of esophagitis.
authors.affiliation: Department of Pediatrics, Universities of Naples, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Cucchiara
authors.forename: L
authors.initials: L
authors.lastname: Gobio-Casali
authors.forename: F
authors.initials: F
authors.lastname: Balli
authors.forename: G
authors.initials: G
authors.lastname: Magazzú
authors.forename: A
authors.initials: A
authors.lastname: Staiano
authors.forename: R
authors.initials: R
authors.lastname: Astolfi
authors.forename: S
authors.initials: S
authors.lastname: Amarri
authors.forename: S
authors.initials: S
authors.lastname: Conti-Nibali
authors.forename: S
authors.initials: S
authors.lastname: Guandalini
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002927:Cimetidine / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D004311:Double-Blind Method; D004942:Esophagitis, Peptic / Q000188:drug therapy* / Q000503:physiopathology; D005764:Gastroesophageal Reflux / Q000188:drug therapy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015337:Multicenter Studies as Topic; D011897:Random Allocation
chemical_list: D002927:Cimetidine