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Gastroesophageal reflux disease (GERD): current agents and future perspective
1Service of Gastroenterology, University Hospital, Zaragoza, Spain. alanas@posta.unizar.es
Current Pharmaceutical Design
|February 15, 2001
Summary
Proton pump inhibitors are key for managing moderate to severe gastroesophageal reflux disease (GERD) and esophagitis. For mild GERD, a step-down approach with proton pump inhibitors or H2-receptor antagonists is cost-effective.
Area of Science:
- Gastroenterology
- Pharmacology
Background:
- Gastroesophageal reflux disease (GERD) management focuses on symptom relief and healing esophagitis.
- Acid suppression is a primary medical treatment strategy for GERD.
Purpose of the Study:
- To outline current and potential future therapeutic strategies for GERD.
- To discuss cost-effective treatment approaches for varying GERD severities.
Main Methods:
- Review of current medical therapies for GERD, including proton pump inhibitors (PPIs) and H2-receptor antagonists.
- Discussion of potential novel therapeutic targets and agents for future GERD treatment.
Main Results:
- For mild GERD or esophagitis, starting with a PPI and stepping down therapy (e.g., to H2-receptor antagonists) is cost-effective.
- PPIs are the mainstay for moderate to severe esophagitis, effectively preventing symptoms.
- Continuous maintenance therapy may not be necessary for all mild GERD patients.
Conclusions:
- Current GERD treatment relies on acid suppression, with PPIs being most effective for moderate to severe cases.
- Future GERD therapies may target lower esophageal sphincter control, motility, mucosal damage, and Barrett's esophagus progression.
- Antireflux surgery is an option for young patients requiring long-term therapy.