Effect of prokinetics in children with recurrent nocturnal retrosternal pain.
BACKGROUND
Children rarely present with vague complaints of nocturnal recurrent retrosternal or upper-abdominal, epigastric, pain. Dysmotility of the upper gastrointestinal tract, including gastro-oesophageal reflux, might be at the origin of these manifestations.


OBJECTIVE
To evaluate the clinical effect of prokinetics (cisapride) in children with recurrent nocturnal retrosternal pain, and to measure the effect of cisapride with a combined oesophageal ambulatory 24 h pH and pressure monitoring.


METHODS
Twelve children, mean age 9.5 years (range 4.1-14.0 years), with nocturnal recurrent retrosternal pain for more than 6 months, occurring at least three times a week.


METHODS
Single-blinded prospective study, with two periods of 2-3 weeks during which cisapride was administered, alternated with two placebo periods of the same duration. Clinical evaluation, and assessment with oesophageal pH and pressure monitoring.


RESULTS
Cisapride was related to a temporary relief of the symptoms in 10/12 children. The improvement was demonstrated through a normalization of pH monitoring, and an increase in amplitude and duration of the contractions in the lower oesophagus.


CONCLUSIONS
Cisapride improves complaints of recurrent nocturnal retrosternal pain in children.
Hegar
B
B
Academisch Ziekenhuis Kinderen, Vrije Universiteit Brussel, Brussels, Belgium.
de Pont
S
S
Vandemaele
K
K
Vandenplas
Y
Y
D002648:Child; D020117:Cisapride / Q000627:therapeutic use*; D005260:Female; D005764:Gastroesophageal Reflux / Q000188:drug therapy*; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008991:Monitoring, Physiologic; D012008:Recurrence; D016037:Single-Blind Method; D016896:Treatment Outcome
D005765:Gastrointestinal Agents; D020117:Cisapride