title: Esophagitis in children: an update on current pharmacotherapy.
abstract: BACKGROUND
  A common diagnostic entity in children is Esophagitis with multiple etiologies and complex immuno-pathogenic mechanisms. Our understanding of these mechanisms and of the pharmacotherapy of esophagitis is still evolving.
  
  
  METHODS
  Areas of focus for this review were chosen based on recent clinical practice and research interest in esophagitis in infants and children. A literature search was conducted with the relevant keywords ('gastroesophageal reflux disease' in pediatric age group, 'eosinophilia', 'esophageal eosinophilia', 'esophagitis', 'eosinophilic esophagitis', 'proton pump inhibitors'). Use, safety and efficacy of proton pump inhibitors in young infants and older children, the concepts of esophageal eosinophilia and overlap of reflux and eosinophilic esophagitis are discussed here.
  
  
  CONCLUSIONS
  Proton pump inhibitors are effective in healing reflux esophagitis in children of all ages but do not improve gastroesophageal reflux related symptoms in infants. An overlap in clinical and histological features of reflux and eosinophilic esophagitis exists, and proton pump inhibitors may exert their action in pathways other than just acid suppression. The role of weakly acidic/alkaline reflux in gastroesophageal reflux symptoms, development of newer reflux modifying medications and tools to assess efficacy of therapeutic intervention in eosinophilic esophagitis are promising areas for further research and developing knowledge.
authors.affiliation: Elliot Hospital, New Hampshire Hospital for Children, Pediatric Gastroenterology and Nutrition , Manchester, NH 03109 , USA hshashidhar@elliot-hs.org.
authors.forename: Harohalli
authors.initials: H
authors.lastname: Shashidhar
authors.forename: Vasundhara
authors.initials: V
authors.lastname: Tolia
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004941:Esophagitis / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D005764:Gastroesophageal Reflux / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D006801:Humans; D007223:Infant; D017410:Practice Guidelines as Topic; D054328:Proton Pump Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic
chemical_list: D054328:Proton Pump Inhibitors