Effects of Proton Pump Inhibitor and Sodium Rabeprazole in the Treatment of Three Children With GERD or Duodenal Ulcer, Estimated by 24 hr pH Monitoring

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  • Okuyama Naoki
    Division of Pediatric Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences
  • Yagi Minoru
    Division of Pediatric Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences
  • Kubota Masayuki
    Division of Pediatric Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences
  • Yamazaki Satoshi
    Division of Pediatric Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences
  • Ohtaki Masahiro
    Division of Pediatric Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences
  • Tanaka Shinji
    Division of Pediatric Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences
  • Kobayashi Kumiko
    Division of Pediatric Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences

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Other Title
  • 小児におけるラベプラゾールナトリウムの使用経験 : 24時間pHモニタリングを用いた効果判定
  • ショウニ ニ オケル ラベプラゾール ナトリウム ノ シヨウ ケイケン 24ジカン pH モニタリング オ モチイタ コウカ ハンテイ

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Abstract

Purpose : PPIs, Proton Pump Inhibitors are widely used in the treatment of gastric ulcers or esophagitis caused by GER in adults. However, proper dosages and method of administration in children still remain unknown. Methods : We used Sodium Rabeprazole in three children with GERD or duodenal ulcer to control gastric acidity and its efficacy was estimated by pH<4 holding time, obtained from 24 hr pH monitoring. Results : For two cases with GERD, Rabeprazole was started at 0.3 mg/kg/day, and then pH<4 holding time was 98.8% or 72.1% respectively. However, 0.5 mg/kg/day was effective and pH<4 holding time decreased to 5.6% in one case, while in another case the effect of Rabeprazole was still insufficient to control gastric acidity and surgical intervention was undertaken. The remaining one case was a 14-year-old girl. She lost 7 kg within 4 months due to the pyloric stenosis caused by A_1 stage duodenal ulcer. Rabeprazole was given at 10 mg/day. Nocturnal gastric acid breakthrough was found about 7 hr at night, so the amount of Rabeprazole was imcreased to 20 mg/day, which provided sufficient control of gastric acidity. The pyloric stenosis and all other symptoms were improved, and her body weight is about 46 kg (+11 kg) now. Conclusion : During this study, no side effects or complications induced by Rabeprazole were found in these cases. The effect of Rabeprazole varies among children and careful monitoring of gastric acidity by 24 hr pH monitoring is necessary to evaluate its efficacy.

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