Proton Pump Inhibitors

Proton Pump inhibitors can play an integral part in treating you baby's infant acid reflux and is just one of the many treatment options available to you and your baby. There are many PPIs to chose from and getting them compounded. Let's start with what they are, how they work and some product names.

proton pump inhibitors

The clinical description of a PPI drug is a chemical compound (the technical name for medicine) that irreversibly inactivates the pumps that produce stomach acid while the medication is in its effective stage (the effective stage refers to the duration when the medicine starts and stops working).

To accurately describe a proton pump we need to describe the parietal cells that are located in the stomach. The function of the parietal cells are to secrete acid into the stomach to assist in breaking down what has been ingested (eaten). Proton pumps are part of this cell's membrane and that is the portion of the cell that pumps out the acid that the parietal cell secretes into the stomach.

PPI's work within the parietal cell's surface where acid is secreting. PPI's reach the location of the parietal cell secretion point through the blood stream. The PPIs react to the cell in a way that inactivates, both the pumps from secreting acid and in turn inactivates the parietal cells from producing acid.

The question is how do PPIs relate to infant acid reflux and are they safe to use and an infant acid reflux treatment? The answer is yes. PPI's are the safest, most effective medications available for treating acid reflux in both infants and children and the following have been approved by the FDA for pediatric use:

  • Esomeprazole, found in Nexium®
  • Omeprazole, found in Zegerid®, Prilosec® and generic forms
  • Lansoprazole, found in Prevacid®
  • Pantoprazole, found in Protonix®

For more in-depth information read the PPI Dosing Information Page This is very helpful in understanding the Marci-kids dosing used by the University of Missouri and Marcella Bothwell ENT and Jeffrey Phillips Pharm D. (Dr. P) in effectively treating infant acid reflux.

Note: The doses recommended in the PPI information page and on the PPI dosing chart are not recommended by any proton pump inhibitor manufacturer or distribution company. These recommendations are representative of typical dosing used at Marci-kids website and have been proven to be effective in most cases.

Proton pump inhibitors should be used under the supervision of your doctor and all treatment options should be discussed with your medical team prior to use.

Proton Pump Inhibitor Categories

There are a number of proton pump inhibitor products on the market today. 

  1. Prescription (Rx)
  2. Over the counter (OTC)

Then they are further categorize as:

  1. Delayed Release PPI: In this form, the PPI is contained in an enteric-coated beads, granules or tablet. The enteric-coating is resistant to stomach acid and allows the medication to be ingested and make it through the acid of the stomach to the small intestine where the PPI is absorbed into the blood stream where it inactivates the production of acid from the parietal cells. So basically if the medication hits the stomach acid in an unprotected form, it would be destroyed by the stomach acid and becomes useless as a treatment. That is the benefit of having the enteric coating, or some sort of protection via capsule, on the drug itself. The downside is, protecting the medication with a coating of some sort also delays the effect until it reaches the small intestine. That process, from the time your baby ingests the proton pump inhibitor, until it takes effect in the small intestine can take up to two hours
  2. Immediate Release PPI: This form of PPI is suspended in an alkaline buffer that neutralizes the stomach acid and it replaces the need of having the enteric coating on the PPI. Zegerid® is currently the only immediate release PPI product that is available in both Rx and OTC and is FDA approved.

Some PPI's come in both OTC and Rx forms. Some examples are lansoprazole and ompeprazole.

This is a great time to pop over to that Acid & pH page and read about how acid and pH levels work, with interactive images that actually show you the process of digestion in a baby.

A proton pump inhibitor can be highly effective in controlling acid production. Additionally they have proven to be very safe and all of the PPIs on the market have very few, if any, side effects. Be sure to read about the contraindications (WHAT NOT TO DO OR USE WHEN USING A PROTON PUMP INHIBITOR) of using PPI's.

PPI Contraindications:
What to avoid giving or doing when administering PPI Drugs in infants with acid reflux.

To assist you in understanding the Proton Pump Dosing regimen as suggested with our products.

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