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Gastroesophageal reflux disease

C N Williams

    Canadian Journal of Gastroenterology = Journal Canadien De Gastroenterologie
    |April 29, 1998
    PubMed
    Summary

    Chronic gastroesophageal reflux disease (GERD) management requires ongoing therapy. Proton pump inhibitors (PPIs) are highly effective for symptom resolution and healing, with surgery an option for refractory cases.

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    Area of Science:

    • Gastroenterology
    • Internal Medicine

    Background:

    • Chronic gastroesophageal reflux disease (GERD) is a persistent condition with significant complications like esophagitis and Barrett's esophagus.
    • Current management strategies involve risk factor modification, acid suppression, and enhancing esophageal motility.

    Purpose of the Study:

    • To review the therapeutic approaches for chronic GERD, focusing on efficacy and management of refractory cases.

    Main Methods:

    • Literature review of current GERD therapies, including non-drug interventions, pharmacotherapy (H2 receptor antagonists, PPIs), prokinetic agents, and surgical options.

    Main Results:

    • Non-drug therapy and patient education are initial steps for uncomplicated GERD.
    • Proton pump inhibitors (PPIs) demonstrate high efficacy (74-96%) in resolving GERD symptoms.
    • Prokinetic agents show inconsistent healing effects, and refractory GERD requires individualized treatment, potentially including combination therapy or surgery.

    Conclusions:

    • Effective management of chronic GERD relies on maintenance therapy, with PPIs being a cornerstone treatment.
    • Endoscopy is indicated for persistent symptoms suggesting complicated disease.
    • Surgical intervention is a viable option for patients with refractory GERD unresponsive to medical management.

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