The Journal of Pediatrics
Volume 152, Issue 3 , Pages 310-314.e1 , March 2008

Efficacy of Conservative Therapy as Taught in the Primary Care Setting for Symptoms Suggesting Infant Gastroesophageal Reflux

Presented in part at the American Gastroenterology Association annual meeting, Washington, DC, May 21, 2007, and published in part as: Orenstein SR, McGowan JD, Duke AL, Taghadosi M, Harris-Ford LA, Harvey BM, Lauzon JD. Efficacy of conservative therapy as taught in the primary care setting for infant reflux symptoms: prospective validated assessment by the I-GERQ-R during the run-in for a placebo-controlled clinical trial of nizatidine oral solution. Gastroenterology 2007;132(4, Suppl 2):A442.

  • Susan R. Orenstein, MD

      Affiliations

    • University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
    • Corresponding Author InformationReprint requests: Susan R. Orenstein, MD, Professor, Pediatric Gastroenterology, University of Pittsburgh School of Medicine, 303 Church Ln, Pittsburgh, PA 15238-1006.
    • ,
  • John D. McGowan, BS

      Affiliations

    • Braintree Laboratories, Braintree, Masschusetts.

Received 4 May 2007 ,Revised 7 August 2007 ,Accepted 5 September 2007.

References 

  1. Shalaby TM, Orenstein SR. Efficacy of telephone teaching of conservative therapy for infants with symptomatic gastroesophageal reflux referred by pediatricians to pediatric gastroenterologists. J Pediatr. 2003;142:57–61
  2. Kleinman L, Rothman M, Strauss R, Orenstein SR, Nelson S, Vandenplas Y, et al. The Infant Gastroesophageal Reflux Questionnaire Revised: Development and validation as an evaluative instrument. Clin Gastro Hep. 2006;4:588–596
  3. Orenstein SR, Shalaby TM, Kelsey SF, Frankel E. Natural history of infant reflux esophagitis: symptoms and morphometric histology during one year without pharmacotherapy. Am J Gastroenterol. 2006;101:628–640
  4. Orenstein SR. When does the maturation process really occur?. In:  Giuli R,  Tytgat G,  DeMeester T,  Galmiche J-P editor. The esophageal mucosa: 300 questions … 300 answers. Amsterdam: Elsevier Science; 1994;p. 748–750
  5. Feranchak AP, Orenstein SR, Cohn JF. Behaviors associated with onset of gastroesophageal reflux episodes in infants: prospective study using split-screen video and pH probe. Clin Pediatr. 1994;33:654–662
  6. Slocum C, Hibbs AM, Martin RJ, Orenstein SR. Infant apnea and gastroesophageal reflux: a critical review and framework for further investigation. Curr Gastro Reports. 2007;9:219–224
  7. Orenstein SR, Hassall E, Di Lorenzo C, Bauman N. Controversies and cases: issues in diagnosis and management of pediatric GERD. Contemp Pediatr. 2007;24:1–6
  8. Ravelli AM, Tobanelli P, Volpi S, Ugazio AG. Vomiting and gastric motility in infants with cow’s milk allergy. J Pediatr Gastroenterol Nutr. 2001;32:59–64
  9. Cavataio F, Iacono G, Montalto G, Soresi M, Tumminello M, Campagna P, et al. Gastroesophageal reflux associated with cow’s milk allergy in infants: which diagnostic examinations are useful?. Am J Gastroenterol. 1996;91:1215–1220
  10. Iacono G, Carroccio A, Cavataoi F, Montalto G, Kazmierska I, Lorello D, et al Gastroesophageal reflux and cow’s milk allergy in infants: a prospective study. J Allergy Clin Immunol. 1996;97:822–827
  11. Justinich C, Kalafus D, Esposito P, Ricci A, Sylvester F, Hyams J, et al. Mucosal mast cells distinguish allergic from gastroesophageal reflux-induced esophagitis (abstract). J Pediatr Gastroenterol Nutr. 1996;23:342
  12. Hill DJ, Heine RG, Cameron DJS, Catto-Smith AG, Chow CW, Francis DEM, et al. Role of food protein intolerance in infants with persistent distress attributed to reflux esophagitis. J Pediatr. 2000;136:641–647
  13. Magazzu G, Scoglio R. Gastrointestinal manifestations of cow’s milk allergy. Ann Allergy Asthma Immunol. 2002;89:65–68
  14. Cavataio F, Iacono G, Montalto G, Soresi M, Tumminello M, Carroccio A. Clinical and pH-metric characteristics of gastro-oesophageal reflux secondary to cows’ milk protein allergy. Arch Dis Child. 1996;75:51–56
  15. Sutphen JL, Dillard VL. Effect of feeding volume on early postcibal gastroesophageal reflux in infants. J Pediatr Gastroenterol Nutr. 1988;7:185–188
  16. Orenstein SR. Infantile reflux: different from adult reflux. Am J Med. 1997;103:114–119S
  17. Orenstein SR, Magill HL, Brooks P. Thickening of infant feedings for therapy of gastroesophageal reflux. J Pediatr. 1987;110:181–186
  18. Khoshoo V, Ross G, Brown S, Edell D. Smaller volume, thickened formulas in the management of gastroesophageal reflux in thriving infants. J Pediatr Gastroenterol Nutr. 2000;31:554–556
  19. Craig WR, Hanlon-Dearman A, Sinclair C, Taback S, Moffatt M. Metoclopramide, thickened feedings, and positioning for gastrooesophageal reflux in children under two years (Cochrane Database Syst Rvw 2004; Most Recent Substantive Amendment: 2004 03 31(4)). http://www.medscape.com/viewarticle/502053CD003502. t 18;(4):CD003502. Accessed May 2, 2007.
  20. Vanderhoof JA, Moran JR, Harris CL, Merkel KL, Orenstein SR. Efficacy of a pre-thickened infant formula: a multi-center, double blind, randomized, placebo-controlled parallel group trial in 104 infants with symptomatic gastroesophageal reflux. Clin Pediatr. 2003;42:483–495
  21. Miyazawa R, Tomomasa T, Kaneko H, Morikawa A. Effect of locust bean gum in anti-regurgitant milk on the regurgitation in uncomplicated gastroesophageal reflux. J Pediatr Gastroenterol Nutr. 2004;38:479–483
  22. Wenzl TG, Schneider S, Scheele F, Silny J, Heimann G, Skopnik H. Effects of thickened feeding on gastroesophageal reflux in infants: a placebo-controlled crossover study using intraluminal impedance. Pediatrics. 2003;111:e355–e359
  23. Borrelli O, Salvia G, Campanozzi A, Franco MT, Moreira FL, Emiliano M, et al. Use of a new thickened formula for treatment of symptomatic gastro-oesophageal reflux in infants. Ital J Gastroenterol Hepatol. 1997;29:237–242
  24. Xinias I, Spiroglou K, Demertzidou V, Karatza E, Panteliadis C. An antiregurgitation milk formula in the management of infants with mild to moderate gastroesophageal reflux. Curr Ther Res. 2003;4:270–278
  25. Vandenplas Y, Xinias I, Mouane , Leluyer B, Hauser B. Cornstarch thickened formula reduces esophageal acid exposure time in infants. J Pediatr Gastroenterol Nutrition. 2004;39:S483–S484
  26. Orenstein SR, Whitington PF, Orenstein DM. The infant seat as treatment for gastroesophageal reflux. N Engl J Med. 1983;309:760–763
  27. Vandenplas Y, Sacre SL. Seventeen-hour continuous esophageal pH monitoring in the newborn: evaluation of the influence of position in asymptomatic and symptomatic babies. J Pediatr Gastroenterol Nutr. 1985;4:356–361
  28. Shenassa ED, Brown MJ. Maternal smoking and infantile gastrointestinal dysregulation: the case of colic. Pediatrics. 2004;114:e497–e505
  29. Alaswad B, Toubas PL, Grunow JE. Environmental tobacco smoke exposure and gastroesophageal reflux in infants with apparent life-threatening events. J Okla State Med Assoc. 1996;89:233–237
  30. Sheikh S, Goldsmith LJ, Howell L, Hamlyn J, Eid N. Lung function in infants with wheezing and gastroesophageal reflux. Pediatr Pulmonol. 1999;27:236–241
  31. Martin A, Pratt N, Kennedy C, Ryan P, Ruffin R, Miles H, et al. Natural history and familial relationships of infant spilling to 9 years of age. Pediatrics. 2002;109:1061–1067
  32. Su C, Lewis JD, Goldberg B, Brensinger CL, Lichtenstein GR. A meta-analysis of the placebo rates of remission and response in clinical trials of ulcerative colitis. Gastroenterology. 2007;132:516–526

 Financial support of the parent clinical trial from which these data were obtained was provided by Braintree Laboratories, Inc. The sponsor did not, however, provide financial support for the current manuscript’s data analysis and preparation. Dr Susan Orenstein drafted the manuscript and was not paid to do so.

PII: S0022-3476(07)00854-2

doi: 10.1016/j.jpeds.2007.09.009

The Journal of Pediatrics
Volume 152, Issue 3 , Pages 310-314.e1 , March 2008

Article Tools

* Image Usage & Resolution