Tag Archives: Gastro-oesophageal reflux

Neonatal Updates

Posted on 11 June 2015 by Keith Barrington

Deshmukh M, et al. Effect of gastric lavage on feeding in neonates born through meconium-stained liquor: a systematic review. Archives of Disease in Childhood – Fetal and Neonatal Edition. 2015. When I first went to one of the hospitals I … Continue reading →

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Acid suppression doesn’t work, and it’s not safe. pHunny how we got here.

Posted on 6 December 2013 by Keith Barrington

Maybe it’s not pHunny at all. A good quality review article about the use of acid blockade for treating what are sometimes called ‘symptoms of reflux’. Rosen R: Gastroesophageal reflux in infants: More than just a pHenomenon. JAMA Pediatrics 2013. … Continue reading →

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GE Reflux… again

Posted on 22 November 2013 by Keith Barrington

Esomeprazole is one of the Proton pump inhibitors that is quite effective at reducing gastric acid production. This RCT of 51 infants (preterms to 1 month of age) randomized babies that had symptoms that were interpreted as being due to … Continue reading →

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Spitting Up, it is normal

Posted on 5 April 2013 by Keith Barrington

A new study in Pediatrics asked parents how they would feel about a hypothetical scenario. They gave a history of a patient who is spitting up, possiting, regurgitating or whatever you want to call it, and either gave it  a … Continue reading →

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Erythromycin: not another toxic placebo!

Posted on 29 November 2012 by Keith Barrington

Erythromycin is an antibiotic. This much is true. It is active against mycoplasma and against ureaplasmas, but is very poor at actually eradicating them. It also stimulates motilin receptors in the bowel, that is why it increases bowel activity, and … Continue reading →

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More about reflux: anti-acid medications may also be toxic placebos

Posted on 28 November 2012 by Keith Barrington

While I am still finalizing my long overdue chapter on gastro-esophageal reflux (sorry Sanjay if you are reading this, it is on its way, honestly) I have been reviewing the data on acid blockade as a potential treatment. Probably the … Continue reading →

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Domperidone for GE reflux; toxic and worse than placebo!

Posted on 6 October 2012 by Keith Barrington

As mentioned in a previous post, to get cisapride for a patient in Canada, you have to contact Health Canada for special permission through the Special Access Program. The last time that I am aware of someone asking Health Canada for special … Continue reading →

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Cisapride for GE reflux; more toxic placebos!

Posted on 6 October 2012 by Keith Barrington

I am currently writing a chapter for a textbook, the chapter will deal with GE reflux. So I have been reviewing the data around various treatment options. I have already written on this blog about the lack of physiologic rationale … Continue reading →

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A toxic placebo

Posted on 8 July 2012 by Keith Barrington

One very frequently used agent in the NICU is metoclopramide, prescribed almost exclusively for gastro-esophgeal reflux, (occasionally in an attempt to improve feeding tolerance). Let us assume for a moment that a baby does have clinical signs which are due to reflux, that … Continue reading →

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