title: Omeprazole for severe reflux esophagitis in children.
abstract: BACKGROUND
  Severe esophagitis is a rare complication of gastroesophageal reflux in children. In adults, omeprazole therapy of severe erosive esophagitis has become the gold standard short-term treatment of the disease. In children, data on its use are limited, and problems about the dosage are unresolved. The aim of this study was to evaluate the efficacy of a simplified, body-weight-based daily dosage of omeprazole in children with severe esophagitis.
  
  
  METHODS
  Ten children (median age 75.6 months; range 25-109 months) with severe esophagitis were prospectively investigated. All patients were evaluated by endoscopy, histology, and 24-h pH-metry study before and after 3 months of omeprazole. The starting dose of omeprazole was 20 mg as a single daily dose in children weighing less than 30 kg, and 40 mg daily for those weighing over 30 kg.
  
  
  RESULTS
  A significant improvement in all the children was demonstrated after 3 months of treatment by clinical, endoscopic, and pH-metry assessment. However, histologic study failed to show significant improvement of both inflammatory and hyperplastic findings. Relapse occurred in six of 10 patients after discontinuation of therapy.
  
  
  CONCLUSIONS
  Omeprazole is effective in the short-term treatment of severe oesophagitis in children. The daily dose of the drug could be easily based on the body weight. The persistence of histologic features of esophagitis in spite of clinical and endoscopic healing could be an indicator of poor outcome.
authors.affiliation: Clinica Pediatrica, Università di Pavia, IRCCS Policlinico, S. Matteo, Italy.
authors.forename: C
authors.initials: C
authors.lastname: De Giacomo
authors.forename: P
authors.initials: P
authors.lastname: Bawa
authors.forename: M
authors.initials: M
authors.lastname: Franceschi
authors.forename: O
authors.initials: O
authors.lastname: Luinetti
authors.forename: R
authors.initials: R
authors.lastname: Fiocca
mesh_terms: D000897:Anti-Ulcer Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004942:Esophagitis, Peptic / Q000188:drug therapy* / Q000503:physiopathology; D004945:Esophagoscopy; D004947:Esophagus / Q000187:drug effects / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D009853:Omeprazole / Q000008:administration & dosage / Q000627:therapeutic use*; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D000897:Anti-Ulcer Agents; D009853:Omeprazole