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Oral ranitidine and duration of gastric pH >4.0 in infants with persisting reflux symptoms.
Acta Paediatr 2006; 95(2):176-81AP

Abstract

BACKGROUND

Ranitidine is a drug commonly used in pathological gastro-oesophageal reflux (GOR) in infants. Non-responsiveness has been reported. Data regarding the effect of ranitidine on oesophageal acid exposure and reduction of gastric acid secretion are limited in this age group.

OBJECTIVE

To evaluate oesophageal acid exposure, reduction of gastric acid secretion and histology of oesophageal biopsies in infants who clinically do not respond to oral ranitidine.

PATIENTS AND DESIGN

103 infants (mean age 3.3 +/- 1.8 mo) with persisting symptoms of reflux despite administration of ranitidine, prescribed previously by a referring physician, at a mean (SD) dose of 9.4 (+/- 3.3) mg/kg/d for at least 2 wk (mean 30 d), were submitted to a 24-h pH study and oesophageal biopsy (90/103 patients).

RESULTS

Histological oesophagitis was present in 21/90 (23%). The oesophageal reflux index (RI) was >5% and >10% in 21/103 (20%) and 6/103 (6%) infants, respectively. Gastric pH was >4.0 during <50%, >50%, >75% and >90% of the duration of pH monitoring in 33/103 (32%), 70/103 (68%), 22/103 (21%) and 7/103 (7%), respectively. By simple regression analysis, the dosage of ranitidine correlated with the oesophageal RI (r = 0.21; p = 0.05), but not with the duration of time gastric pH was >4.0 (r = 0.09; p = 0.39). Histological oesophagitis did not correlate with ranitidine dosage, duration of treatment, duration gastric pH was >4.0 and oesophageal reflux index.

CONCLUSION

Some infants presenting with symptoms assumed to be GOR and acid related fail to respond to acid suppression with ranitidine, either because they need better acid suppression or because the symptoms are not acid related.

Authors+Show Affiliations

Clinica Pediatrica di Varese, Università dell'Insubria, Varese, Italy.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16449023

Citation

Salvatore, Silvia, et al. "Oral Ranitidine and Duration of Gastric pH >4.0 in Infants With Persisting Reflux Symptoms." Acta Paediatrica (Oslo, Norway : 1992), vol. 95, no. 2, 2006, pp. 176-81.
Salvatore S, Hauser B, Salvatoni A, et al. Oral ranitidine and duration of gastric pH >4.0 in infants with persisting reflux symptoms. Acta Paediatr. 2006;95(2):176-81.
Salvatore, S., Hauser, B., Salvatoni, A., & Vandenplas, Y. (2006). Oral ranitidine and duration of gastric pH >4.0 in infants with persisting reflux symptoms. Acta Paediatrica (Oslo, Norway : 1992), 95(2), pp. 176-81.
Salvatore S, et al. Oral Ranitidine and Duration of Gastric pH >4.0 in Infants With Persisting Reflux Symptoms. Acta Paediatr. 2006;95(2):176-81. PubMed PMID: 16449023.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Oral ranitidine and duration of gastric pH >4.0 in infants with persisting reflux symptoms. AU - Salvatore,Silvia, AU - Hauser,Bruno, AU - Salvatoni,Alessandro, AU - Vandenplas,Yvan, PY - 2006/2/2/pubmed PY - 2006/6/21/medline PY - 2006/2/2/entrez SP - 176 EP - 81 JF - Acta paediatrica (Oslo, Norway : 1992) JO - Acta Paediatr. VL - 95 IS - 2 N2 - BACKGROUND: Ranitidine is a drug commonly used in pathological gastro-oesophageal reflux (GOR) in infants. Non-responsiveness has been reported. Data regarding the effect of ranitidine on oesophageal acid exposure and reduction of gastric acid secretion are limited in this age group. OBJECTIVE: To evaluate oesophageal acid exposure, reduction of gastric acid secretion and histology of oesophageal biopsies in infants who clinically do not respond to oral ranitidine. PATIENTS AND DESIGN: 103 infants (mean age 3.3 +/- 1.8 mo) with persisting symptoms of reflux despite administration of ranitidine, prescribed previously by a referring physician, at a mean (SD) dose of 9.4 (+/- 3.3) mg/kg/d for at least 2 wk (mean 30 d), were submitted to a 24-h pH study and oesophageal biopsy (90/103 patients). RESULTS: Histological oesophagitis was present in 21/90 (23%). The oesophageal reflux index (RI) was >5% and >10% in 21/103 (20%) and 6/103 (6%) infants, respectively. Gastric pH was >4.0 during <50%, >50%, >75% and >90% of the duration of pH monitoring in 33/103 (32%), 70/103 (68%), 22/103 (21%) and 7/103 (7%), respectively. By simple regression analysis, the dosage of ranitidine correlated with the oesophageal RI (r = 0.21; p = 0.05), but not with the duration of time gastric pH was >4.0 (r = 0.09; p = 0.39). Histological oesophagitis did not correlate with ranitidine dosage, duration of treatment, duration gastric pH was >4.0 and oesophageal reflux index. CONCLUSION: Some infants presenting with symptoms assumed to be GOR and acid related fail to respond to acid suppression with ranitidine, either because they need better acid suppression or because the symptoms are not acid related. SN - 0803-5253 UR - https://www.unboundmedicine.com/medline/citation/16449023/Oral_ranitidine_and_duration_of_gastric_pH_>4_0_in_infants_with_persisting_reflux_symptoms_ L2 - https://doi.org/10.1080/08035250500327609 DB - PRIME DP - Unbound Medicine ER -