Safe Mark, Chan Wei H, Leach Steven T, Sutton Lee, Lui Kei, Krishnan Usha
Mark Safe, Usha Krishnan, Department of Paediatric Gastroenterology, Sydney Children's Hospital, Randwick NSW 2031, Australia.
World J Gastrointest Pharmacol Ther. 2016 Nov 6;7(4):531-539. doi: 10.4292/wjgpt.v7.i4.531.
Gastroesophageal reflux is a common phenomenon in infants, but the differentiation between gastroesophageal reflux and gastroesophageal reflux disease can be difficult. Symptoms are non-specific and there is increasing evidence that the majority of symptoms may not be acid-related. Despite this, gastric acid inhibitors such as proton pump inhibitors are widely and increasingly used, often without objective evidence or investigations to guide treatment. Several studies have shown that these medications are ineffective at treating symptoms associated with reflux in the absence of endoscopically proven oesophagitis. With a lack of evidence for efficacy, attention is now being turned to the potential risks of gastric acid suppression. Previously assumed safety of these medications is being challenged with evidence of potential side effects including GI and respiratory infections, bacterial overgrowth, adverse bone health, food allergy and drug interactions.
胃食管反流在婴儿中是一种常见现象，但区分胃食管反流和胃食管反流病可能会很困难。症状不具有特异性，而且越来越多的证据表明，大多数症状可能与胃酸无关。尽管如此，质子泵抑制剂等胃酸抑制剂的使用却越来越广泛，而且常常在没有客观证据或检查来指导治疗的情况下使用。几项研究表明，在没有内镜证实的食管炎的情况下，这些药物在治疗与反流相关的症状方面无效。由于缺乏疗效证据，现在人们的注意力转向了胃酸抑制的潜在风险。这些药物以前被认为是安全的，但现在正受到潜在副作用证据的挑战，这些副作用包括胃肠道和呼吸道感染、细菌过度生长、骨骼健康不良、食物过敏和药物相互作用。
