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Acid-suppressing medications may be overprescribed for infants
Date:10/20/2011

Frequent spitting up, irritability and unexplained crying in infants are often very distressing to parents. Physicians frequently prescribe acid-suppressing drugs for these symptoms. However, gastroesophageal reflux disease (GERD) is an uncommon cause of these symptoms in otherwise thriving infants, and in his commentary published in the Journal of Pediatrics, Dr. Eric Hassall cautions against over-diagnosis of GERD and over-prescription of acid-suppressing drugs in children under one year of age.

Dr. Hassall, a member of the division of gastroenterology at BC Children's Hospital, a professor of pediatrics at the University of British Columbia, and an advisor to the U.S. Food and Drug Administration, traces the history and current uses of acid-suppressing medication in children and infants, mostly focusing on proton pump inhibitors (PPIs). He points out that clinical studies have shown PPIs to be highly effective in children 1 to 17 years of age who have proven GERD.

In children under the age of one year, the use of these drugs has enormously increased in the last decade, a change in medical practice that Dr. Hassall says is not based in medical science. The rise of prescriptions owes a lot to direct-to-consumer advertising of pharmaceutical products, with its promotion of the misleading term "acid reflux," frequent self-misdiagnosis, and demand for medication. As Dr. Hassall observes, "it is recognized that more advertising leads to more requests by patients for advertised medicine, and more prescriptions; the term 'acid reflux' as used in the marketing of PPIs to adults, has simply trickled down to infants." He points out that most "reflux" in infants is not "acid," because stomach contents have been buffered by frequent feedings.

Randomized, controlled studies have shown that PPIs are no better than placebo for most infants with symptoms of spitting up and irritability, or unexplained crying. Dr Hassall explains that this is
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Contact: Brian Kladko
brian.kladko@ubc.ca
604-827-3301
University of British Columbia
Source:Eurekalert

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