[Therapy of gastroesophageal reflux disease (GERD)]

Gastroesophageal reflux disease (GERD) comprises all symptoms and clinical consequences in the context of reflux of stomach contents into the esophagus. The symptoms reported by patients include heartburn, regurgitation and sour taste in the mouth. In some cases atypical reflux associated symptoms such as asthma, laryngitis or recurrent pneumonias are reported. Pathophysiologically an incompetence of the lower esophageal sphincter and a disturbed clearance of the esophagus are the underlying mechanisms. Current treatment recommendations include a change of lifestyle and a drug treatment with proton pump inhibitors (PPI) being widely used. In patients with persistent symptoms other diagnoses like functional dyspepsia should be considered especially when additional symptoms like epigastric pain, postprandial fullness and nausea are present. This review summarizes the current understanding of the pathophysiology, the diagnosis and the treatment of GERD and gives an outlook on therapies currently developed for the treatment of reflux disease. A promising new drug, presently classified as being a reflux inhibitor, is lesogaberan. Lesogaberan is presently studied in phase II clinical trials.