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All Journal The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
Aldo Reynaldo
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Medicine & Pharmacology

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Proton Pump Inhibitors Therapy in Children with Gastroesophageal Reflux Aldo Reynaldo; Badriul Hegar
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 3, December 2013
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (439.384 KB) | DOI: 10.24871/1432013158-164

Abstract

Proton pump inhibitors (PPI) has been widely used by clinicians to treat diseases that require suppression of gastric acid. PPI work by inhibiting the proton pump in gastric parietal cells.In adult patients, PPI hasbeen widely studied and showed effective results and safe. This result make PPI positioning as the first choice medicine in the treatment of diseases that require suppression of gastric acid. As the primary choice therapy, PPI administration has been increased not only in adults but also in children.PPI is often administered to children with a diagnosis of gastroesophageal reflux disease (GERD) which defined as symptoms or complications caused by gastroesophageal reflux (GER). GERD diagnosis in children is quite difficult, so it is common to find that diagnosis is established only by the basis of clinical symptoms, resulting in overdiagnosis and over-treatment of GERD. The use of PPI in children still needs further study andcan not be inferred based on adult studies. Inappropropriate PPI prescription without indication will increase side effect, risk and also harm the children. Thus, it is important to know the indications, side effects and safety of PPI therapy in children.Keywords: proton pump inhibitor, children, gastroesophageal reflux disease
Esophagus and Its Function Related to Gastro-esophageal Reflux Badriul Hegar; Aldo Reynaldo; Yvan Vandenplas
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 13, NUMBER 3, Desember 2012
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (320.109 KB) | DOI: 10.24871/1332012166-173

Abstract

ABSTRACTThe main function of the esophagus is to transport food from the mouth into stomach. Anatomical structures, innervations and blood supplies are needed in order to transport the food into stomach. Mastication stimulates the parasympathetic nerves that regulate salivary, gastric and pancreatic secretion. Saliva secretion stimulates swallowing and increases primary esophageal peristalsis, helps in clearing the esophagus from refluxed material. Swallowing induces peristaltic of esophagus that propulses a solid bolus down the esophagus into the stomach.      Innervations are important for esophagus to do its function. One of the most important is coordination between the various reflexes. Delayed clearance of acid from the esophageal and decreased pressure of the lower sphincter esophagus (LES) are the major mechanisms involved in the development of esophagitis. The resistance of the mucosa to the noxious effect of the refluxed material (acid, pepsin, chymotrypsin and trypsin, bile, etc.) is different from person to person. The LES pressure is a defense mechanisms to prevent gastro-esophageal reflux disease (GERD). The LES pressure decreases postprandially. The frequency of postprandinal GER is related to the meal size. Gastric bolus feeding is related to greater intragastric pressure causes more of transient LES relaxations. Osmolality and volume of the feeding slow gastric emptying and incrase postprandial GER. The occurrence of GERD is associated with whether or not the preventive factors are functioning. Other preventive factors for GERD are esophageal peristalsis, secretion and mucosal resistance, gravity and position, the LES tone and angle of his. Patient with GERD should be searched for any disturbances on those factors. Keywords: gastroesophageal reflux diseases, lower esophageal sphincter, esophagitis, peristaltic 
Co-Authors Badriul Hegar Yvan Vandenplas