PPI's are the most effective medication used to control reflux. They almost completely shut down the acid pumps in the stomach.

More Detail About The Actions of Proton Pump Inhibitors

The proton pump is the final stage in acid secretion so shutting down the proton pump provides the best defense in controlling acid by affecting not just the action of histamine but all three pathways of acid production. Proton Pump Inhibitors (PPI's) act by blocking the proton pump (hydrogen-potassium adenosine triphosphatase enzyme system-the K+/H+-ATPase) of the parietal cell. This almost completely stops acid production. Proton pump inhibitors are typically tried after histamine blockers have failed, as the cost can be more than double that of the histamine blockers. They are significantly more effective than H2 blockers and said to reduce gastric acid secretion by up to ninety-nine percent.

Because these types of meds are delayed-release, the manufacturers of these drugs recommend that they not be chewed or crushed. Omeprazole (Prilosec®) and lansoprazole (Prevacid®) are available as enteric-coated granules in capsules (referred to as "beads" or "pellets"). In addition, a new oral suspension formulation of lansoprazole was FDA-approved in January 2002.

Currently, the manufacturers of lansoprazole and esomeprazole include instructions on the administration of the granules in applesauce, water or acidic juices for oral administration. In addition, the package inserts for lansoprazole and esomeprazole state that the granules or pellets within the capsules may be administered down a gastric tube after mixing with an acidic juice or water. The marketed formulations of the PPIs limit their use to patients that can swallow. However, some of the PPIs can be made into a liquid, permitting their use for patients that cannot swallow, have difficulty swallowing, or have gastric feeding tubes. The following are preparations the pharmaceutical manufacturers suggested and have been evaluated for effectiveness relative to the capsule or tablet form.

Common Proton Pump Inhibitors Used In Infants and Children:

Other Proton Pump Inhibitors:

• Aciphex® (Rabeprazole)

• Nexium® (Esomeprazole)

• Protonix® (Pantoprozole)