Real Illness or Not?

by Sue Redmond

Should Doctors prescribe for a “non-disease”?

1775R-21494Infants spit up.  Many on a daily basis (some studies show as high as 40-70%).  Just one of the reasons may be that they drink a large volume of liquids and have a short esophagus.  About 95% of these infants stop spitting up without any treatment by age 12 to 15 months.  Even though they have the “symptoms” of reflux, they don’t actually have the disease.  Why then are more and more babies and infants labeled with a “disease”?  The incidence of a diagnosis of GERD in infants tripled from 2000 to 2005. With disease comes treatment.  Proton Pump Inhibitors are the drug of choice.  Approximately 50% of infants who start on PPI’s are under 4 months.  The US Food and Drug Administration has not even approved the use of PPI’s for use in infants under one year old.  In 2009, a randomized, placebo-controlled trial examining how well a PPI worked for infants with symptoms of GERD was published. It found that the drug had no more of an effect than a placebo. It also found that children who received the PPI had significantly more serious adverse events, including respiratory tract infections.

Do commercials about prescription medications have an effect on parents?  Do they feel better when doctors give them something to “treat” their baby?  Is this a reason for doctors to go ahead and prescribe?  Some things we need to think about.

http://www.nytimes.com/2014/06/03/upshot/calling-an-ordinary-health-problem-a-disease-leads-to-bigger-problems.html?action=click&contentCollection=Business%20Day&module=MostEmailed&version=Full&region=Marginalia&src=me&pgtype=article&_r=1
Carroll, Aaron E. “Calling an Ordinary Health Problem a Disease Leads to Bigger Problems.” The UpShot. The New York Times, 2 Jun 2014. Web. 15 Jun 2014.

http://www.jpeds.com/article/S0022-3476(11)00897-3/fulltext
Hassall, Eric. “Over-Prescription of Acid-Suppressing Medications in Infants: How It Came About, Why It’s Wrong, and What to Do About It.” The Journal of Pediatrics, 24 Oct 2011. Web. 15 Jun 2014.

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