Proton Pump Inhibitors (PPI’s)continue to be the mainstay of pharmacotherapy in all children with Gastroesophageal Reflux Disease(GERD). They have replaced the H2 receptor antagonists as they provide sustained acid suppression.
Esomeprazole/Lansoprazole/Pantaprazole/Omeprazole- all in a dose of 1 to 2 mg/kg/day
The efficacy of each of these is comparable. If the child is not responding to one he will not respond to a change in PPI salt either.
Duration of therapy for GERD should be atleast 2 to 3 weeks. If the child does not respond, the dose can be increased for another two weeks. No response at the end of 6 weeks should stimulate the clinician to look for an alternative diagnosis as several disorders like achalasia cardia, etc. can present with similar symptoms.
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