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ESPGHAN SURVEY ON THE USE OF PROTON PUMP INHIBITORS FOR GASTRO-ESOPHAGEAL REFLUX DISEASE IN INFANTS AND CHILDREN
1.
Which is your country of practice ?
2.
Which is your setting of Practice?
University Hospital
Paediatric Hospital
General Hospital
Private clinic
General Practitioner Service
Paediatric Service – outpatient clinic
Other (please specify)
3.
Which is your Specialty?
Paediatric
Gastroenterology
Neonatology
Allergology
Pneumology
ENT
Neurology
Intensive care /Emergency
Surgery
Other (please specify)
4.
Which symptoms do you consider to start proton pump inhibitors (PPI) in infants? (more than one answer allowed)
Episodes of apnea or desaturation
Unexplained persistent crying and/or distressed behavior
Unexplained chronic cough
Sleep disturbances
Feeding refusal
Poor growth
Other (please specify)
None of the above
5.
Which symptoms do you consider to start PPI in children and adolescents? (more than one answer allowed)
Heartburn/pyrosis
Epigastric pain
Dysphonia
Dysphagia
Unexplained chronic cough
Sleep disturbances
Recurrent respiratory infections
Other (please specify)
None of the above
6.
Do you use a specific questionnaire to record symptoms before starting PPI?
Only in infants
Only in children
Only in adolescents
Please specify questionnaire based on response above
None of the above
7.
Which investigation do you consider to diagnose reflux esophagitis before starting PPI? (more than one answer allowed)
Esophageal ultrasonography
Contrast radiography
Upper endoscopy
Esophageal biopsy
Esophageal pH-impedance
Laryngoscopy
None
8.
Which investigation do you consider to diagnose reflux symptom association before starting PPI? (more than one answer allowed)
Esophageal ultrasonography
Contrast radiography
Upper endoscopy
Esophageal pH-impedance
Esophageal pH-monitoring
Laryngoscopy
None
9.
If you consider esophageal pH-impedance, based on which parameters do you start PPI ? (more than one answer allowed)
Acid reflux exposure
Total number of reflux
Symptoms indexes associated with acid reflux
Symptoms indexes associated with acid and non acid reflux
Uncertain
I don’t consider esophageal pH-impedance to start PPI
10.
If you consider laryngoscopy, based on which findings do you prescribe PPI? (more than one answer allowed)
Laryngeal erythema
Laryngeal edema
Vocal cord granuloma/nodules
Positive reflux finding score
Uncertain
I don’t consider laryngoscopy to start PPI
Other (please specify)
11.
When do you prescribe PPI in infants ? (more than one answer allowed)
If erosive esophagitis
If pathological pH-impedance
If pathological laryngoscopy
If abnormal esophageal ultrasound
If episodes of reflux on contrast X-Ray
If suspected symptoms of reflux disease
Never
12.
When do you prescribe PPI in children ? (more than one answer allowed)
If erosive esophagitis
If pathological pH-impedance
If pathological laryngoscopy
If sleep disturbances
If suspected symptoms of reflux disease
Uncertain
13.
When do you prescribe PPI in neurological impaired children? (more than one answer allowed)
If erosive esophagitis
If pathological pH-impedance
If pathological laryngoscopy
If episodes of reflux on contrast X-Ray
If sleep disturbances
If unexplained abdominal pain/ crying
If poor feeding
Always
Uncertain
14.
Which PPI do you prescribe in children with reflux disease ? (more than one answer allowed)
Omeprazole
Esomeprazole
Lansoprazole
Pantoprazole
15.
How long do you usually prescribe PPI after a symptom-based diagnosis of reflux disease?
Two-four weeks
Four-six weeks
Eight-twelve weeks
More than three months
16.
How long do you usually prescribe PPI after the endoscopic diagnosis of esophagitis ?
Two-four weeks
Four-six weeks
Eight-twelve weeks
More than three months
17.
What do you do if your patient does not respond to PPI? (more than one answer allowed)
Double the dose
Change molecule
Reconsider the diagnosis
Perform an endoscopy
Perform a pH-impedance
Refer to a Paediatric Gastroenterologist
18.
How do you generally discontinue PPI therapy? (more than one answer allowed)
After disappearance of symptoms
After demonstration of healing of esophagitis
After demonstration of normal pH-impedance
Abrupt discontinuation
Gradual weaning
Uncertain
19.
Which of these do you consider as the most frequent adverse event of PPI therapy?
Bone fractures
Infections
Allergic reaction
Diarrhea
Interstitial nephritis
Headache
Uncertain
Other (please specify)
20.
Have you read the ESPGHAN-NASPGHAN guidelines on reflux disease published in 2018?
No, I did not know about it
No, because they are too long
No, because I don’t like guidelines
I can’t remember
Yes
Current Progress,
0 of 20 answered