PROTON PUMP INHIBITORS IN THE TREATMENT OF PEDIATRIC GERD: SAFETY CONCERNS
Keywords:
Gastroesophageal reflux disease, GERD, children, proton pump inhibitors, PPI safety, adverse effects, pediatric gastroenterology, acid suppression therapyAbstract
Gastroesophageal reflux disease (GERD) is a common gastrointestinal disorder in children, characterized by the retrograde flow of gastric contents into the esophagus, leading to symptoms such as regurgitation, heartburn, feeding difficulties, and, in severe cases, esophagitis. Proton pump inhibitors (PPIs) are widely used as first-line pharmacological therapy due to their potent acid-suppressive effects, demonstrated efficacy in symptom relief, and promotion of esophageal mucosal healing. However, increasing evidence has raised concerns regarding the safety profile of PPIs in pediatric populations, particularly with long-term use. Potential adverse effects include alterations in gut microbiota, increased risk of gastrointestinal infections, nutrient malabsorption, bone mineral density reduction, and rare but serious renal complications. Clinical studies emphasize the importance of weighing therapeutic benefits against potential risks, tailoring PPI use to appropriate indications, and monitoring treatment duration. This review synthesizes current evidence on the safety considerations of PPI therapy in children with GERD, highlighting the need for judicious prescription, vigilant monitoring, and exploration of alternative or adjunctive strategies. Understanding these safety issues is essential to optimizing clinical outcomes while minimizing unintended consequences in the pediatric population.
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