Dr. Eisner Anwers your GERD Questions: Is Nexium safe for kids?
My 9 year-old has been diagnosed with GERD. Is it safe for him to be on Nexium?
Yes. Earlier this year, the FDA approved Nexium for short-term use in children ages 1-11 years for the treatment of gastroesophageal reflux disease. Both the liquid and delayed-release pill forms were approved. As opposed to children ages 12-17, the approved dose for younger children is 10-20 mg a day, for eight weeks. Most common side effects were headache, diarrhea and abdominal pain. At this point, use of Nexium in children under the age is 1 is not recommended. You should check with your child’s pediatrician to see if there are any contraindications to him starting the drug.
I am a 35 year old female who has been suffering from GERD symptoms the past few months. I tried taking Prilosec-OTC and more recently Nexium without relief. Any suggestions?
There are many reasons why the medications you have taken might not be controlling your symptoms. First of all, you must make sure that your symptoms are caused by gastroesophageal reflux disease. Other possibilities include pill-induced esophagitis, eosinophilic esophagitis, achalasia, as well as non-gastrointestinal causes of chest pain. Medications that commonly cause pill-induced esophagitis are doxycycline and tetracycline naproxen, potassium chloride, ascorbic acid, quinidine and ferrous sulphate. If your doctor thinks that reflux is the cause, perhaps you need to be taking higher doses of proton pump inhibitors. About 20% of patients with gastroesophageal reflux disease that take proton pump inhibitors need to take two pills a day to control their symptoms. Additionally, timing of medications is important. Nexum, Prilosec and Prevacid must be taken 30 minutes to an hour before breakfast to have maximal efficacy. All of the proton pump inhibitors work best when taken in the morning. If twice a day dosing at the correct time doesn’t work, an interesting thing to consider is a change to H2 receptor blockers like Pepcid or Zantac. In some patients, more commonly females, proton pump inhibitors are rapidly metabolized, and have little effect. While generally not as potent as proton pump inhibitors, H2 receptor blockers might work better if that is the case. You should check with your doctor to see what the next step should be in the evaluation of your symptoms.
I have Barrett’s esophagus. A friend of mine read somewhere that raspberries can be beneficial in patients with Barrett’s. Is this true?
A small study earlier this year at Ohio State University’s Comprehensive Cancer Center revealed that this might be the case. Patients with Barrett’s Esophagus were given a black raspberry powder and water mix. Forty percent had a boost in a protective enzyme and sixty percent saw a decline in oxidative stress, which can cause cell damage. It is felt that the combination of strong anti-oxidants, muti-vitamins and minerals found in black raspberries potentially would lead to an positive impact on progression of Barrett;s While larger studies are needed, it certainly can’t hurt to add it to your diet.
Read what expert Dr. Bryan Vartabedian writes about the decision to make Nexium approved for children.
For more information on GERD medications for children or infants, click here.
Todd wrote for HealthCentral as a patient expert for Digestive Health.