title: Widespread use of gastric acid inhibitors in infants: Are they needed? Are they safe?
abstract: Gastroesophageal reflux is a common phenomenon in infants, but the differentiation between gastroesophageal reflux and gastroesophageal reflux disease can be difficult. Symptoms are non-specific and there is increasing evidence that the majority of symptoms may not be acid-related. Despite this, gastric acid inhibitors such as proton pump inhibitors are widely and increasingly used, often without objective evidence or investigations to guide treatment. Several studies have shown that these medications are ineffective at treating symptoms associated with reflux in the absence of endoscopically proven oesophagitis. With a lack of evidence for efficacy, attention is now being turned to the potential risks of gastric acid suppression. Previously assumed safety of these medications is being challenged with evidence of potential side effects including GI and respiratory infections, bacterial overgrowth, adverse bone health, food allergy and drug interactions.
authors.affiliation: Mark Safe, Usha Krishnan, Department of Paediatric Gastroenterology, Sydney Children's Hospital, Randwick NSW 2031, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Safe
authors.affiliation: Mark Safe, Usha Krishnan, Department of Paediatric Gastroenterology, Sydney Children's Hospital, Randwick NSW 2031, Australia.
authors.forename: Wei H
authors.initials: WH
authors.lastname: Chan
authors.affiliation: Mark Safe, Usha Krishnan, Department of Paediatric Gastroenterology, Sydney Children's Hospital, Randwick NSW 2031, Australia.
authors.forename: Steven T
authors.initials: ST
authors.lastname: Leach
authors.affiliation: Mark Safe, Usha Krishnan, Department of Paediatric Gastroenterology, Sydney Children's Hospital, Randwick NSW 2031, Australia.
authors.forename: Lee
authors.initials: L
authors.lastname: Sutton
authors.affiliation: Mark Safe, Usha Krishnan, Department of Paediatric Gastroenterology, Sydney Children's Hospital, Randwick NSW 2031, Australia.
authors.forename: Kei
authors.initials: K
authors.lastname: Lui
authors.affiliation: Mark Safe, Usha Krishnan, Department of Paediatric Gastroenterology, Sydney Children's Hospital, Randwick NSW 2031, Australia.
authors.forename: Usha
authors.initials: U
authors.lastname: Krishnan
keywords: Adverse events; Gastroesophageal reflux; Infants; Proton pump inhibitors; Ranitidine; Safety