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Education before Medication

Education before medication, please What is GERD? GERD in infants Gastro Spitting up (GER or "reflux" - the backward flow of stomach contents Esophageal up into the esophagus or the mouth) is normal in most infants as their immature digestive systems develop. It is self-resolving in almost all infants by 1 year of age. GERD is rare and more serious, and occurs when complications from GER arise, such as failure to gain weight, bleeding, respiratory problems or esophagitis. Reflux Disease Diagnosis of GERD: Two main indicators of GERD are: Spitting Up "Up to 70% of infants spit up on a daily basis." - Dr. Eric Hassall, Journal of Pediatrics, Vol.160, No. 2, February 2012 Crying "All infants cry...the median duration of crying is 3 hours per day, and in 1/3 of healthy infants crying can exceed 3 hours per day." - Dr. Richard Haber, Parkhurst Exchange, Vol. 19, No.1, February 2011 & However, both of these are NORMAL behaviors for most infants. True diagnosis of GERD includes... Endoscopy Esophageal pH Biopsy X-Ray Proton Pump Inhibitors (PPI) and H2 Blockers are the most common medications prescribed by doctors for the treatment of GERD, but... Fewer than 10% of the infants receiving had any diagnostic testing. Journal Pediatric Gastroenterology and Nutrition, Vol. 45, No. 4, October 2007 "Babies have been crying and spitting up since time immemorial. But these days many parents ask: Isn't there a drug for that? 'Parents often come in demanding medication,' says Eric Hassall, a pediatric gastroenterologist. Hassall says some parents have picked up on the idea that heavily advertised medicines for reflux in adults can help fussy babies who spit up a lot." - "Second Thoughts on Medicines For Babies Who Spit Up", NPR, November 2011 Explosive Growth of Acid Blockers: PPI prescriptions dispensed to patients less than 1 year old had an The estimated number of infants (<12 months old) with a filled PPI prescription rose from approximately 18,000 patients in 2002 to 145,000 patients in 2009. 11-fold increase during this 8-year period. - FDA Gastrointestinal Drugs Advisory Committee, November 5, 2010 In the 8 years from 2002 through 2009, there was an 8-fold increase in PPI use in children - Ime less than 1 year old. 2002 2003 2004 2005 2006 2007 2008 2009 FDA, Pediatric Focused Safety Review, June 2010 SDI, Vector One®: National, Data Extracted May 2010 SDI, Vector One: Total Patient Tracker, Data Extracted May 2010 The results of four clinical trials show that these medicines work no better than a placebo in treating infants with reflux. - The Journal of Pediatrics, October 20, 2011 "Second Thoughts on Medicines For Babies Who Spit Up", NPR, November 2011 The FDA has NOT approved PPIS for children younger than one year. So, What's the Harm? Stomach acid is essential for proper absorption of nutrients. By suppressing stomach acid, acid blockers have a number of potential side effects, especially for infants. Here are the most common... Short Term Long Term Acid blockers reduce absorption of key nutrients: Headache Vitamin B12 is key to normal brain Dizziness development Drowsiness Folic Acid helps prevent defects in the brain and spine Runny Nose Calcium builds teeth and bones Dry Mouth Insufficient production of the enzyme Pepsin can lead to food allergies Nausea Abdominal Pain Zinc supports healing and the immune system Constipation Iron aids formation of red blood cells Difficult Urination Magnesium helps maintain normal muscle and nerve function Diarrhea Increased Risk of Infection As part of the immune system, stomach acid protects infants from infection by killing harmful microbes and bacteria ingested with food. Additional Sources: Jonathan Wright, Lane Lenard: Why Stomach Acid Is Good for You: Natural Relief from Heartburn, Indigestion, Reflux and GERD, August 2001 Ryan D. Madanick, MD: Proton pump inhibitor side effects and drug interactions: Much ado about nothing?, Cleveland Clinic Journal of Medicine, January 2011 - Whittekin, Martie, Natural Alternatives to Nexium, Maalox, Tagamet, Prilosec & Other Acid Blockers: What to Use to Relieve Acid Reflux, Heartburn, and Gastric Ailments, June 2008 - Sherry Rogers, MD: No More Heartburn - Stop Pain in 30 Days Naturally, January 2000 - L. B. Bobroff: Facts about Calcium, University of Florida, March 2012 Harding S.: Gastroesophageal reflux and asthma: Insight into the association. J Allergy Clin Immunol. 1999, 104: 251-259 Bezwoda W, Charlton R, Bothwell T, Torrance J, Mayet F.: The importance of gastric hydrochloric acid in the absorption of nonheme food iron. J Lab Clin Med. 1978, 92: 108-116. 8. Pedrosa M, Russell R.: Folate and vitamin B12 absorption in atrophic gastritis. In: Holt P, Russell R, eds. Chronic Gastritis and Hypochlorhydria in the Elderly, pp. 157-169. Boca Raton, FL: CRC Press. 1993. Russell RM, Golner BB, Krasinski SD, Sadowski JA, Suter PM, Braun CL.: Effect of antacid and H2 receptor antagonists on the intestinal absorption of folic acid. J Lab Clin Med. 1988, 112: 458-463. Sturniolo GC, Montino MC, Rossetto L, et al. Inhibition of gastric acid secretion reduces zinc absorption in man. J Am Coll Nutr. 1991, 10: 372-375. - Office of Dietary Supplements, NIH; Dietary Supplement Fact Sheet on Magnesium Colic Calm coliccalm.com/PPI-infographic BY NO ND •(* •(* •¢* •¢> •(* •¢* •¢> •€

Education before Medication

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The number of babies prescribed acid suppression drugs such as H2 blockers and PPIs grew 8-fold during 2002 to 2009, but fewer than 10% received any diagnostic testing for GERD (Gastroesophageal Reflu...

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