Can proton pump inhibitors cause intestinal inflammation in children?
Abstract
Proton pump inhibitors (PPIs) such as lansoprazole, esomeprazole, pantoprazole, and rabeprazole are currently among the most frequently prescribed medications in both adults and children. In the pediatric population, PPIs are indicated for the treatment of gastroesophageal reflux disease (GERD), erosive esophagitis, gastric ulcers, Helicobacter pylori infection, and eosinophilic esophagitis. 1) Although evidence from most clinical trials of PPIs in children with GERD have demonstrated that adverse events do not significantly differ between PPI-treated and placebo groups, case control studies have revealed an increased risk of infections including necrotizing enterocolitis, pneumonia, upper respiratory tract infections, sepsis, urinary tract infections, and Clostridium difficile infection (CDI) with PPI use. 2) The underlying mechanism of these adverse events associated with PPI use is related to their acid inhibition effect, which is mostly observed during long-term treatment. 3) PPIs increase gastric pH, which decreases the bactericidal effect of the gastric juices and can lead to a higher susceptibility to infections. In the gastrointestinal tract, the chance of infection These could been statistically significant in a larger number of possible for the discrepancy between the 2 is the duration of PPI usage.
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