Cisapride doesn’t work? Don’t go breakin’ my heart!  

Oleh:

Shulman, Robert J.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The Journal of Pediatrics vol. 134 no. 3 (Mar. 1999), page 262-264.
Topik: GER ; Gastroesophageal reflux; GERD ; Gastroesophageal reflux disease

Ketersediaan

Perpustakaan FK Nomor Panggil: J45.K Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

It was not so long ago that gastroesophageal reflux had a small place in the daily practice of pediatricians. It now seems to be one of the most common problems encountered and has become the bane of many pediatric subspecialties (eg, gastroenterology, pulmonology, otolaryngology, surgery). We now know much more about the pathogenesis of GER. However, as the article by Cohen et al1 in this issue of The Journal highlights, we know much less about what to do about it. Recent data suggest that in many infants, and older children and adults for that matter, an underlying mechanism of GER is transient (albeit inappropriate) relaxation of the lower esophageal sphincter. Consequently, GER is primarily a motor disease; and the use of a prokinetic agent such as cisapride, which stimulates esophageal clearance, increases the tone of the lower esophageal sphincter, and enhances gastric emptying, makes empiric if not scientific sense. Acid suppression with drugs such as proton pump inhibitors does a better job of treating esophagitis, but these drugs do not alter the underlying motility disorder.5 Would administration of a promotility agent truly be of benefit—in fact of great enough benefit—to accept the reported proarrhythmia effect of cisapride?

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