title: Effect of proton pump inhibition on acid, weakly acid and weakly alkaline gastro-esophageal reflux in children.
abstract: BACKGROUND
  The effect of proton pump inhibitors on the characteristics of gastroesophageal reflux (GER) in children and adolescents was evaluated.
  
  
  METHODS
  Twenty-one children and adolescents with symptoms suggesting GER disease (GERD) underwent upper endoscopy and a 24-hour multichannel intraluminal impedance/pH (MII-pH) monitoring before and at the end of 2 months of therapy with proton pump inhibitors (PPIs).
  
  
  RESULTS
  Fourteen (67%) patients reported clinically relevant symptom improvement after 2 months of PPIs intake. At the first endoscopy, 8 (38%) patients had macroscopic signs of reflux esophagitis; after two months of therapy, 6/8 (75%) patients had a complete mucosal recovery. There was a significant reduction in the total percentage of mean acid reflux time (from 13.1% to 3.8%), and the De Meester score dropped to normal (from 46.4 to 13.1). The mean number of acid refluxes decreased significantly from 48 to 15 per 24 hours, while inversely, the mean number of weakly acid refluxes increased significantly from 26 to 64 per 24 hours. PPI therapy did not affect the total number of reflux episodes, the number of liquid and mixed refluxes, the duration of esophageal bolus exposure and proximal extent of the reflux.
  
  
  CONCLUSIONS
  In children and adolescents with GERD, PPIs do not affect the total number of reflux episodes. PPIs only decrease the acidity of refluxate. Nevertheless, the majority of patients with typical reflux symptoms may report symptom improvement. Esophagitis can be healed after PPI treatment. The treatment of weakly acid and weakly alkaline reflux remains a challenge for physicians in the future.
authors: University Children's Hospital, University Medical Centre, Ljubljana, Slovenia.
authors: Helena
authors: H
authors: Turk
authors: Bruno
authors: B
authors: Hauser
authors: Jernej
authors: J
authors: Brecelj
authors: Yvan
authors: Y
authors: Vandenplas
authors: Rok
authors: R
authors: Orel
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D050782:Esophageal pH Monitoring; D005260:Female; D005745:Gastric Acidity Determination; D005764:Gastroesophageal Reflux / Q000188:drug therapy* / Q000378:metabolism*; D006801:Humans; D008297:Male; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*
chemical_list: D054328:Proton Pump Inhibitors
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