Reducing dyspeptic symptoms in children: proton pump inhibitor vs. H2 receptor antagonist

Abstract

Background Dyspepsia is known as a leading cause of upper
gastrointestinal tract morbidity. If left untreated, dyspepsia may
become chronic. Dyspeptic symptoms manifest as epigastric
pain, heartburn, nausea, hematemesis, or melena. Experimental
studies have shown that omeprazole is more effective at reducing
heartburn than ranitidine in adults. However, there have been
few studies comparing the effects of proton pump inhibitors
to Hz receptor antagonists for reducing dyspeptic symptoms in
children.
Objective To compare the effect of omeprazole with ranitidine
for reducing dyspeptic symptoms .
Methods We performed a double-blind randomized controlled
trial (RCT) at Sardjito Hospital and three community h ealth
centers in the Sleman District from June to November 2012.
We recruited children aged 3-18 years with dyspepsia. Subjects
were allocated into two groups using block randomization:
the proton pump inhibitor (omeprazole) and the Hz receptor
antagonist (ranitidine) groups. According to the groups, either
omeprazole (0.4-0 .8 mg/kg/dose) or ranitidine (2-4 mg/kg/dose) ,
respectively, were taken twice daily for 5 days. Dyspepsia was
clinically diagnosed using the new Rome III criteria. Both groups
were monitored for 5 days to assess for a reduction of dyspeptic
symptoms.
Results Significantly more subjects in the omeprazole group
recovered from dyspeptic symptoms than in the ranitidine group
(RR= 4.87; 95%CI 1.5 to 15.3; P=0.005).
Conclusion Omeprazole was 4.87 (95% CI 1.5 to 15.3) times
better than ranitidine in reducing dyspeptic symptoms on children
aged 3-18 years with dyspepsia.