A THERAPEUTIC APPROACH FOR THE MANAGEMENT OF GASTROESOPHAGEAL REFLUX DISEASE IN INFANTS

Mr. Naveen Kumar M.Pharm Research Scholar, Department of Pharmacology, Noida Institute of Engineering and Technology (Pharmacy Institute), Plot no-19, Knowledge Park-II, Greater Noida, Uttar Pradesh-201306
Dr. Avijit Mazumder Director and professor of Pharmacology, Noida Institute of Engineering and Technology (Pharmacy Institute), Plot no-19, Knowledge Park-II, Greater Noida, Uttar Pradesh-201306
Dr. Saumya Das Associate professor, Department of Pharmacology, Noida Institute of Engineering and Technology (Pharmacy Institute), Plot no-19, Knowledge Park-II, Greater Noida, Uttar Pradesh-201306
Mr. Amit Bind M.Pharm Research Scholar, Department of Pharmacology, Noida Institute of Engineering and Technology (Pharmacy Institute), Plot no-19, Knowledge Park-II, Greater Noida, Uttar Pradesh-201306

Abstract

Regurgitation of stomach contents into esophagus is known as gastro-esophageal reflux disease (GERD). Infants are more prone to GERD due to frequent vomiting and regurgitation. Overfeeding with carelessness toward the infant diet is common cause of GERD prevalence in infants. The present review focused on the various pharmacological and non-pharmacological approaches used in the current context to treat GERD in infants. Non-pharmacological method is safe over pharmacological method for treating GERD in infants. Non pharmacological methods include infants positioning, gastric clearance, proper feeding volume and frequency, removing obesity, thickening agents prevents disease progression and decrease reflux disease by preventing infant’s exposure to certain risk factor of GERD. Maintaining gastric clearance by using thickening agents of standard quality of cereals, starch and xanthan guar gum, carob bean and soybean polysaccharides improve the digestion of infants but also reduce the GERD progression and enhance nutritional value of infants’ feeds. Pharmacological method includes giving medication that reduce the acidity of stomach but also treat the GERD in infants. Several medication antacids, alginates, probiotics, Histamine 2 receptor antagonists, proton pomp inhibitors are given to infants to treat GERD. PPIs are first choice of drugs given to GERD patients as compared to histamine 2 receptor antagonists and prokinetic agents. Antacid and alginate protect oesophagus by reducing acidity and increasing viscosity in stomach. Proton pump inhibitors and histamine 2 receptor antagonists reduce acid secretion by inhibiting the function of receptor underlying the stomach. Prokinetic agents increase motility of stomach and reduce obesity. Medication is given according to age, weight, and severity of GERD in infants. Choice of medication with proper dosage form is important for effective therapy. Nissen fundoplication, Linx procedure, Roux-en-Y gastric bypass are effective surgical methods. In Surgical procedure Nissen fundoplication have highest success rate to treat GERD Surgery reduces the long term medical therapy.

Keywords:

Obesity, Gastroesophageal reflux disease, Non-pharmacological methods, Pharmacological methods, Regurgitation,


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