Profile and assessment of GERD pharmacotherapy

The choice of a medical therapy to treat gastroesophageal reflux disease (GERD) centers around several factors, including the efficacy and safety of the agent and the severity of the patient's symptoms and complications. Although the efficacy of antacids and alginic acid has not been proven definitively in clinical trials, these agents are effective against mild GERD symptoms in clinical practice. Along with sucralfate, these agents are also useful in special populations, such as pregnant women, for whom acid-suppressive therapy may not be the best option. The withdrawal of cisapride from the US market has lessened the role of promotility agents for treating GERD, as their efficacy must be weighed against their side effects. Acid-suppressive agents have become the drugs of choice for GERD. Both proton pump inhibitors (PPIs) and histamine H2-receptor antagonists effectively and safely treat GERD. However, PPIs have been shown to provide the highest levels of GERD symptom relief and esophageal healing to the most patients, in the shortest time, and with the fewest side effects.