6/13/2018 1 Carlo Di Lorenzo, M.D Twitter: @carlodilorenzo1 'Fake News' in GI: Getting to the Truth about Gluten, PEG 3350 and PPIs Disclosure I have the following financial relationships with the manufacturer(s) of commercial product(s) and/or provider of commercial services discussed in this CME activity: Consultant for: Sucampo, Merck, Allergan, QOL Inc I do intend to discuss unapproved/investigative uses of commercial products/devices in my presentation.
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6/13/2018
1
Carlo Di Lorenzo, M.D
Twitter: @carlodilorenzo1
'Fake News' in GI: Getting to the Truth
about Gluten, PEG 3350 and PPIs
Disclosure
I have the following financial relationships with the
manufacturer(s) of commercial product(s) and/or
provider of commercial services discussed in this CME
activity:
Consultant for: Sucampo, Merck, Allergan, QOL Inc
I do intend to discuss unapproved/investigative uses of
commercial products/devices in my presentation.
6/13/2018
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Social media and “fake news” bring a new challenge per
Percent of NICU admissions, where lansoprazole,ranitidine, or metocolpramide was administered,among 4 NICUs within a single healthcare system
Barney CK, et al. Advances in Neonatal Care 2009,9:129-131
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Can an accurate diagnosis of infant GERD be based upon symptoms
such as “irritability”?
Diagnosis of GERD in infants?
• Symptoms including regurgitation, colic/irritability, and vomiting are common among otherwise normal infants (Iacono G et al, Dig Liver Dis, 2005;37:432-8)
• Symptoms of GER are indistinguishable from those of food allergy (Venter C , et al JACI 2006;1118; Sampson H.A.
JACI 2004;806, Savino F et al Eur J Clin Nutr. 2006;1304)
Clostridium Difficile: Retrospective study in children
Aliment Pharmacol Ther. 2010;31:754-9
Recurrent C. Difficile
Risk is further increased by concomitant use of antibiotics and
PPI, whereas H2RAs may be less harmful
Kwok CL et al. Am J Gastroenterol 2012;107:1011-9
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Pediatrics 2012;129:e40–e45
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Decreased acid barrier
Altered microbiome
Attenuation of the immune response
Direct effects of the bacteria
Decreased effectiveness of antibiotics
Stark CM et al. J Pediatr 2016;168:16-22
Recently published and all over the lay press…
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Gomm W, et al. JAMA Neurol. 2016 Feb 15
Dementia• 73,679 participants >75 y/o and free of dementia at baseline
• Patients receiving regular PPI medication (n = 2950) were found to have a significantly increased risk of incident dementia compared with the patients not receiving PPI medication (n = 70,729)