Pharmacologic control of gastro-esophageal reflux in infants with cisapride |
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Authors: | H. Rode R. J. Stunden A. J. W. Millar S. Cywes |
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Affiliation: | (1) Department of Paediatric Surgery, University of Cape Town and Red Cross War Memorial Children's Hospital, Rondebosch, 7700 Cape, Republic of South Africa |
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Abstract: | Autonomic receptors in the upper gastro-intestinal tract permit pharmacologic manipulation of esophageal and gastric function. A new non-anti-dopaminergic, non-cholinergic, prokinetic agent, cisapride, was evaluated to determine it's efficacy in controlling gastro-esophageal reflux (GER) in infancy. Forty infants, mean age 6.5 months, were studied and their response to therapy determined by continuous measurement of lower esophageal pH over a 36-hour period. Five parameters were assessed in the erect, supine, and prone positions, both before and during short-term cisapride therapy. The drug was effective in reducing GER in 86% of the infants studied. Those infants who had a poor overall response to therapy could be identified retrospectively by the lack of improvement in esophageal acid clearance and frequency of reflux episodes; anatomic abnormalities were present in the majority of this subgroup. Cisapride is considered to be effective in the short-term treatment of primary GER of infancy, and a more prolonged assessment is indicated.Offprint requests to: H. Rode |
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Keywords: | Gastro-esophageal-reflux infants pharmacologic control Cisapride |
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