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

Main Article Content

Tien Budi Febriani
Titis Widowati
Mohammad Juffrie

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.

Article Details

How to Cite
1.
Febriani T, Widowati T, Juffrie M. Reducing dyspeptic symptoms in children: proton pump inhibitor vs. H2 receptor antagonist. PI [Internet]. 31Aug.2014 [cited 16Sep.2019];54(4):198-01. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/638
Section
Articles
Received 2016-09-16
Accepted 2016-09-16
Published 2014-08-31

References

1. Deh ghani SM, Imanieh MH, Oboodi R, Haghighat M. The comparative study of the effectiveness of cimetidine, ranitidine, famotidine, and omeprazole in treatment of children with dyspepsia. ISRN Pediatrics. 2011;article ID 219287, doi:10.5402/2011/219287.
2. Hyams JS, Wyllie R, Kay M. Pediatric gastrointestinal and liver disease. 4th ed. Philadelphia: Saunders; 2011.
3. Hegar B. Terapi infeksi Helicobacter pylori pada anak. 1999. Naskah lengkap Konika Jakarta.
4. Perri F, Pastore M, Leandro G, Clemente R, Ghoos Y, Peeters M, et al. Helicobacter pylori infection and growth delay in older children. Arch Dis Child. 1997;77:46-9.
5. Santoso RY. Penggunaan obat golongan proton pump inhibitor (omeprazol) pada terapi tukak lambung. 2008 Jan 4; [cited 2012 November 10]: [about 4 screens]. Available from: http://yosefw.wordpress.com/2008/01/04
6. Evangelista S. Overview on gastrointestinal pharmacology in Pharmacology. 2007; [cited 2012 November 15]; Vol.l: [about 10 screens]. Available from: http://www.eolss.net/Sample-Chapters/C03;E6-8l-12.pdf
7. Ali T, Roberts DN, Tierney WM. Long-term safety concerns with proton pump inhibitors. Am J Med. 2009;122:896-903.
8. Armstrong D, Veldhuyzen van Zanten SJ, Barkun AN, Chiba N, Thomson AB, Smyth S, et al. Heartburn-dominant, uninvestigated dyspepsia : comparison of 'PPI-start' and 'H2 RA-start' management strategies in primary care-the CADET-HR Study. Aliment Pharmacol Tuer. 2005;21:1189-202.
9. Di Mario F, Dotto P, Vianello F, Germana, B, Grassi SA, Del Favero G, et al. Effects of H2 blockers and omeprazole on peptic secretion: a prospective, randomized study in duodenal ulcer subjects. Acta Gastroenterol Belg. 1993;56:223-8.
10. Gillen D, Wirz AA, Ardilt JE, McColl KE. Rebound hypersecretion after omeprazole and its relation to onĀ­treatment acid suppression and Helicobacter pylori status. Gastroenterology. 1999;ll6:293-47.
11. Thompson WG. H2 blockers: indications, effectiveness and long-term use. Milwaukee: International Foundation for Functional Gastrointestinal Disorders. 2009.