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Are acid-suppressing drugs prescribed too often in infants?
Date:10/19/2011

Cincinnati, OH, October 20, 2011 Frequent spitting up, irritability, and unexplained crying in infants can be very distressing to parents. Pediatricians often prescribe acid-suppressing drugs for these symptoms in an effort to treat infants for gastroesophageal reflux disease (GERD); however, GERD is an uncommon cause of these symptoms in otherwise thriving infants. In a soon to be published Commentary in The Journal of Pediatrics, Eric Hassall, MBChB, FRCPC, FACG, cautions against the over-diagnosis of GERD and over-prescription of acid-suppressing drugs in infants.

Dr. Hassall is affiliated with the Department of Pediatrics at the University of British Columbia, Vancouver, Canada, is currently Staff Gastroenterologist at Sutter Pacific Medical Foundation in San Francisco, California, and is an advisor to the U.S. Food and Drug Administration (FDA). Although the FDA has only approved the use of acid-suppressing drugs, such as proton pump inhibitors (PPIs), in children over the age of one year, the use of PPIs in infants less than 12 months old has greatly increased in the last decade.

Dr. Hassall notes that most "reflux" in infants is not acidic because stomach contents have been buffered by frequent feedings. "However, in the absence of better information and physician guidance and fed by advertising and misinformation on the Internet, distressed parents take their concerns to doctors, who very frequently comply and prescribe acid-suppressing medications for symptoms and signs that, in most cases, are not GERD," he states.

Studies have shown that PPIs are no better than placebo for most infants with symptoms of spitting up, irritability, or unexplained crying, which may be because the medications are frequently prescribed for symptoms that are not GERD. Dr. Hassall emphasizes that spitting up in otherwise healthy infants is normal and resolves with time. Irritability or unexplained crying, with or without spitting up,
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Contact: Brigid Huey
ournal.pediatrics@cchmc.org
513-636-7140
Elsevier Health Sciences
Source:Eurekalert

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