Efficacy of Proton-Pump Inhibitors in Children With Gastroesophageal Reflux Disease: A Systematic Review: a systematic review

Rachel J. van der Pol, Marije J. Smits, Michiel P. van Wijk, Taher I. Omari, Merit M. Tabbers, Marc A. Benninga

Research output: Contribution to journalReview articleAcademicpeer-review

191 Citations (Scopus)


INTRODUCTION: Use of proton-pump inhibitors (PPIs) for the treatment of gastroesophageal reflux disease (GERD) in children has increased enormously. However, effectiveness and safety of PPIs for pediatric GERD are under debate. OBJECTIVES: We performed a systematic review to determine effectiveness and safety of PPIs in children with GERD. METHODS: We searched PubMed, Embase, and the Cochrane Database of Systematic Reviews for randomized controlled trials and crossover studies investigating efficacy and safety of PPIs in children aged 0 to 18 years with GERD for reduction in GERD symptoms, gastric pH, histologic aberrations, and reported adverse events. RESULTS: Twelve studies were included with data from children aged 0-17 years. For infants, PPIs were more effective in 1 study (compared with hydrolyzed formula), not effective in 2 studies, and equally effective in 2 studies (compared with placebo) for the reduction of GERD symptoms. For children and adolescents, PPIs were equally effective (compared with alginates, ranitidine, or a different PPI dosage). For gastric acidity, in infants and children PPIs were more effective (compared with placebo, alginates, or ranitidine) in 4 studies. For reducing histologic aberrations, PPIs showed no difference (compared with ranitidine or alginates) in 3 studies. Six studies reported no differences in treatment-related adverse events (compared with placebo or a different PPI dosage). CONCLUSIONS: PPIs are not effective in reducing GERD symptoms in infants. Placebo-controlled trials in older children are lacking. Although PPIs seem to be well tolerated during short-term use, evidence supporting the safety of PPIs is lacking. Pediatrics 2011; 127: 925-935
Original languageEnglish
Pages (from-to)925-935
Number of pages11
Issue number5
Publication statusPublished - May 2011


  • 2-Pyridinylmethylsulfinylbenzimidazoles/administration & dosage
  • Adolescent
  • Age Factors
  • Child
  • Child, Preschool
  • Cross-Over Studies
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Female
  • Gastroesophageal Reflux/diagnosis
  • Humans
  • Incidence
  • Infant
  • Lansoprazole
  • Male
  • Netherlands
  • Omeprazole/administration & dosage
  • Prognosis
  • Proton Pump Inhibitors/administration & dosage
  • Randomized Controlled Trials as Topic
  • Risk Assessment
  • Treatment Outcome

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