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[Internal medicine therapy in reflux disease]
1Medizinische Klinik, Fachbereich Gastroenterologie, Städtische Kliniken Esslingen.
Praxis
|November 5, 1996
Summary
Gastro-oesophageal reflux disease (GERD) management involves symptom relief and complication prevention. Treatment escalates from initial trials to proton pump inhibitors, with dosages adjusted for disease severity and symptom recurrence.
Area of Science:
- Gastroenterology
- Pharmacology
Context:
- Gastro-oesophageal reflux disease (GERD) is a prevalent gastrointestinal disorder.
- Effective management aims to alleviate symptoms, prevent complications, and reduce disease recurrence.
Purpose:
- To outline current treatment strategies for GERD based on symptom presentation and disease severity.
- To guide therapeutic decisions from initial empirical trials to targeted pharmacotherapy.
Summary:
- Initial GERD treatment for isolated heartburn includes antacids, sucralfate, prokinetics, H2-receptor antagonists, or low-dose proton pump inhibitors (PPIs).
- For refractory symptoms or specific presentations, diagnosis-guided therapy is initiated. Mild-to-moderate GERD: acute treatment with 20-40 mg PPIs (omeprazole, lansoprazole, pantoprazole), maintenance with low-dose omeprazole (10 mg).
- Severe GERD: acute treatment with 40-80 mg PPIs, maintenance with omeprazole (20 mg). Maintenance therapy is titrated based on symptoms and endoscopic findings in severe cases.
Impact:
- Provides a clear treatment algorithm for clinicians managing GERD patients.
- Highlights the importance of individualized therapy based on disease severity and patient response.
- Supports evidence-based practice in GERD pharmacotherapy and long-term management.