Too Many Meds Down Junior’s Throat?
11 CommentsBy Ed Silverman // October 4th, 2007 // 9:36 am
That’s the take-away from reading the latest data alert issued by Medco Health Solutions, the big pharmacy benefits manager that helps clients find ways to cut back on prescription-drug spending. This time, Medco reviewed claims of more than 575,000 insured children and found the number of kids taking meds to treat tummyaches has soared in the past five years - up 56 percent between 2002 and 2006.
Usage among school-age kids between 5 and 11 years old rose 31 percent during that time. Among youngsters between 12 and 18, the increase was only 6 percent. Biggest problems cited: heartburn and GERD, or acid reflux. And so the amount spent on GI meds rose 50 percent during the same stretch. The reason: higher usage of meds and more expensive proton pump inhibitors coming to market. Last year, about 2 million kids used GI meds.
“This analysis does raise questions about why we’re seeing an increase in drug treatment for pediatric gastrointestinal disorders,” Rene Jenkins, a pediatrician and president-elect of the American Academy of Pediatrics, says in a Medco statement. Okay, so why are we seeing this trend? Medco suggests prescription meds may be used unnecessarily.
“While there are babies that require drug treatments for extreme cases of GERD and other gastrointestinal problems,” says Robert Epstein, Medco’s chief medical officer, “in some cases, parents and physicians may be looking to medications when non-drug treatments might be adequate.”
todd
Wow, kids on more GI meds for heartburn.
I wonder if it is due to the incredible number of fat kids I see. Or the increasingly worse diets they eat. Or the amount of time spent in front of the TV. Or parents who refuse to leave without a scrip because a pill is easier than parenting.
No, it is the pharma companies. Not society, not kids, not parents, not effective treatments available for kids.
Also, look at the data connecting ped GERD and potential for asthma. Let’s ignore positive data
Donna
Todd,
Understanding that certain “gastrointestinal disorder’s” require medication…somehow Mom’s famous word’s keep ringing in my ear “Maybe if you did’nt eat so much junk your stomach would’nt hurt”…and a little quiet time on the throne alway’s took care of it. My mom’s a smart lady…
Adriana
GI problems are part of the cascade of disorders associated with environmentally-induced “autism”, which should really be renamed something like environmental neuroimmune disorder. Theoretically, there are many kids who, while they don’t appear to be cognitively effected, may share some of the associated physical syndromes, such as autoimmune-based food allergies (peanut “allergies”, celiac disease, intolerance of dairy, etc.) or reflux, intestinal scarring, nutritional malabsorbtion and other disorders.
Andrew Wakefield is currently being pilloried in England for drawing the association between the MMR vaccination and something known as “leaky gut” (which can also imply leaky blood-brain barrier). A series of autistic children were found with pieces of the vaccine-strain measles virus in their intestinal mucosi and cerebrospinal fluid. Many of these kids also have massive yeast overgrowth in their guts.
What role mercury plays in intestinal issues is debatable, though some parents call the sydrome of leaky gut, intestinal scarring and yeast overgrowth “metal gut”, and find that chelating the mercury along with treating the yeast and avoiding allergens helps with or even cures the GI problems.
Of course, the other obvious culprits in the rise in kiddy GI problems would be food additives, junk food and the increasing use of psychotropic medications for younger and younger children.
Not to mention the lead in toys and children’s products. We just had a lead inspector over to our house to officially scan our kids’ toys. Along with some plastic and metal cars from the crappy toy sections at major chain grocery stores and drug stores, only two our our children’s twenty or so Thomas trains passed the test- 80% of which were not on the company’s recall list.
Dr. Herbert Needleman’s studies of lead poisoning report that children may show serious and permanent damage from just half the current EPA limit for lead exposure. One of the symptoms of lead poisoning is- tada- tummy ache.
todd
Donna,
I think that was the point of the first part of my post - parents are more to blame than pharma companies.
Also, endoscopies for peds were MUCH more common before PPI’s were released and used in peds. So, for your 1 year old, which would you rather have happen — be placed on a studied, safe, and effective medication with little risk (look up the safety profiles of these drugs - 17 years with little problems) or have you child strapped down, put out and have a scope put down their throat? Right after you sign off on the risk of infection, perforation, anesthetic issues, and possibly death.
I am going to go with the pill myself. I know it is easier to hate a faceless big company - but it seems like in this case it helps more than it is “greed”
Adriana - you are scarier than Scientologists, help yourself.
Cindy
Todd, how do you explain all of the infants with Eosinophilic Disorders and parenteral feedings? Oh mother must be at fault for eating junk during pregnancy. Never mind.
Lisa Van S
Todd.
May I offer you some Motherly advice?…….Please refrain from Mommy Bashing.
It makes you appear inhumane…
and secondly, it doesnt help, it harms,.. the Industry’s Image.
Hank
I don’t have the relevant studies (does anyone?), but I strongly doubt that there has been an actual upsurge (so to speak) of GERD among kids.
The link between weight, diet, and GERD is uncertain at best. So also is the link between GERD and esophageal cancer. Even for Barrett’s there is some question.
We also don’t know what the very long-term AE profile for PPIs are, particularly if you start in childhood. And, yes, I have looked at the adult data.
Given what we know, and what we don’t know, I think the “smart money” would not be on the side of using PPIs in this quantity for kids.
Donna
Todd,
Think i’m gonna have to go with the scope for starter’s, then we can talk treatment option’s….also i did’nt quite understand your last comment about Scientologist’s????? . They take medication…
todd
Cindy - the treatment for eosinophilic esophagitis is not PPI’s. They are of suspect efficacy in that area. The treatment is corticosteroids with good results.
Hank, try a medline search. Look for yourself. There is data both looking at the link between acid reflux and asthma as well as other breathing disorders. Also you can find ped patients on PPI’s for up to 17 continuous years. You can buy PPI’s OTC, tens of millions of people have taken them for decades. If you can’t trust PPI’s, you shouldn’t take any meds. Omeprazole has been approved in peds for almost a decade. I am not making up data, find it on your own if you don’t trust the source.
Donna - if you really think subjecting your child to an invasive procedure is better than empiric treatment — we will certainly have to agree to disagree. Also keep in mind, GI’s make all their money off scopes. Kind of like surgeons who like to do surgery. Not really the objective person to decide either is it?
todd
Also, for those of you who HATE off-label use of drugs.
There is currently no approved treatment for eosinophilic esophagitis. The steroids or acid suppression are purely off-label. Although this condition is being diagnosed more often, there is no one in the world that would pursue the label. So any treatment does not work in the purists world that inhabit this blog. So if your child has eos esoph, I guess they will have to learn to live with it. Now, I think there is enough data out there to support effective treatment, but then you have to trust academic researchers and studies published in journals that have pharma ads in them. As we can see, not everyone is willing to do that.
Adriana
I just read in Wired mag that a staff counsel for Electronic Frontiers Foundation, Mike Godwin, noted that the longer a heated online discussion continued, the more likely it became that someone would compare another listmate to Hitler. The phenomenon became known as Godwin’s Law. A new law needs to be coined for online pharma discussions to describe the inevitability that someone, at some point, will be compared to a “Scientologist” if they question anything pharmaceutical.
As far as I know, It’s Christian Scientists who don’t take meds. Scientologists take medication, just not psychotropic medication. But, hey, look how Godwin’s Law applies here: Hitler and the Luftwaffe were on the eqivalent of Adderall. So I suppose the whole discussion can be reduced to a claymation Hitler vs. L. Ron Hubbard smackdown.