Histamine Blockers for Reflux May Cause Bowel Infection in Infants

Histamine Blockers

Researchers at the National Institute of Child Health and Human Development Neonatal Research Network have found that premature infants receiving a common class of nonprescription drugs (his-tamine H2 blockers), which are used to treat acid reflux, may have a higher risk for developing a potentially fatal bowel disorder than infants who do not receive the drugs.

H2 blockers such as famotidine canadian (Pepcid drug, Merck), nizatidine (Axid, Reliant), and GlaxoSmithKline’s cimetidine (Tagamet) and tablet ranitidine (Zantac drug) inhibit the production of stomach acid, but they may also cause necrotizing enterocolitis, a serious intestinal inflammation.

Necrotizing enterocolitis affects 5% to 10% of infants born very prematurely. The tissue lining the intestinal wall dies, the surviving tissue becomes swollen and inflamed, and the GI tract cannot digest or transport food. Sometimes parts of the intestines must be removed, or the damage may be so severe that the infant dies.

Physicians sometimes prescribe H2 blockers for premature infants to prevent esophageal damage if the infant is experiencing acid reflux, to reduce excessive stomach acid (which can lead to stomach ulcers) in infants being fed through an esophageal tube, and to possibly prevent sleep apnea (although data are inconclusive).

The researchers hypothesized that by decreasing acidity in the digestive tract, H2 blockers might cause an excess level of gram-negative bacteria, which in turn might lead to necrotizing enterocolitis. Gram-negative bacteria are usually harmless, but their numbers can increase to unhealthy levels when sufficient stomach acid is lacking. They also advise that the drugs be prescribed with caution for premature infants.