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Gastroesophageal reflux disease: pathophysiology and pharmacology overview.
J Assoc Acad Minor Phys 2000; 11(1):7-11JA

Abstract

Gastroesophageal reflux disease (GERD) is one of the most frequently encountered illnesses in the Western Hemisphere. GERD encompasses a spectrum of disorders in which reflux of gastric content into the esophagus causes symptoms and/or damage to the esophagus, oropharynx, or respiratory tract. This article provides a brief update on the pathophysiology and pharmacology of drugs used for the treatment of GERD. The etiology of GERD is multi-factorial and is believed to be principally a consequence of altered motility states in the esophagus and stomach. The drugs used for the treatment of GERD are continuously evolving, but as yet no drug has been shown to cure this chronic, relapsing disease. Antacids, prokinetics, and gastric antisecretory agents are the principal drugs currently used to treat GERD in conjunction with life-style modifications. Due to their ultrashort duration of buffering action, antacids are primarily used as self-medication for temporary relief of mild GERD symptoms. The prokinetic drug cisapride effectively resolves symptoms and heals mild-to-moderate esophagitis, with efficacy similar to that of the histamine H2-receptor antagonists. H2-receptor antagonists exhibit moderate inhibition of gastric acid secretion and are effective for resolving symptoms and healing mild-to-moderate esophagitis. In addition, H2-receptor antagonists slightly augment the therapeutic efficacy of cisapride for healing mild-to-moderate esophagitis. However, use of H2-receptor antagonists at higher doses and higher frequency approaches the efficacy of proton pump inhibitors in healing erosive esophagitis. Given their potent and long-lasting acid-reducing efficacy, proton pump inhibitors have become the drugs of choice for many patients with GERD. Despite progress in the medical treatment of GERD, there are still several unresolved questions relating to cost-effective strategies with specific drugs, how long pharmacologic therapy should be maintained, and when surgical intervention is warranted. Additional studies are clearly needed to address the unresolved treatment issues in GERD.

Authors+Show Affiliations

International Drug Development Consultants (IDDC) Corporation, Long Grove, Illinois 60047-9532, USA. esamd@aol.com

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10826019

Citation

Dajani, E Z.. "Gastroesophageal Reflux Disease: Pathophysiology and Pharmacology Overview." Journal of the Association for Academic Minority Physicians : the Official Publication of the Association for Academic Minority Physicians, vol. 11, no. 1, 2000, pp. 7-11.
Dajani EZ. Gastroesophageal reflux disease: pathophysiology and pharmacology overview. J Assoc Acad Minor Phys. 2000;11(1):7-11.
Dajani, E. Z. (2000). Gastroesophageal reflux disease: pathophysiology and pharmacology overview. Journal of the Association for Academic Minority Physicians : the Official Publication of the Association for Academic Minority Physicians, 11(1), pp. 7-11.
Dajani EZ. Gastroesophageal Reflux Disease: Pathophysiology and Pharmacology Overview. J Assoc Acad Minor Phys. 2000;11(1):7-11. PubMed PMID: 10826019.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Gastroesophageal reflux disease: pathophysiology and pharmacology overview. A1 - Dajani,E Z, PY - 2000/5/29/pubmed PY - 2000/6/10/medline PY - 2000/5/29/entrez SP - 7 EP - 11 JF - Journal of the Association for Academic Minority Physicians : the official publication of the Association for Academic Minority Physicians JO - J Assoc Acad Minor Phys VL - 11 IS - 1 N2 - Gastroesophageal reflux disease (GERD) is one of the most frequently encountered illnesses in the Western Hemisphere. GERD encompasses a spectrum of disorders in which reflux of gastric content into the esophagus causes symptoms and/or damage to the esophagus, oropharynx, or respiratory tract. This article provides a brief update on the pathophysiology and pharmacology of drugs used for the treatment of GERD. The etiology of GERD is multi-factorial and is believed to be principally a consequence of altered motility states in the esophagus and stomach. The drugs used for the treatment of GERD are continuously evolving, but as yet no drug has been shown to cure this chronic, relapsing disease. Antacids, prokinetics, and gastric antisecretory agents are the principal drugs currently used to treat GERD in conjunction with life-style modifications. Due to their ultrashort duration of buffering action, antacids are primarily used as self-medication for temporary relief of mild GERD symptoms. The prokinetic drug cisapride effectively resolves symptoms and heals mild-to-moderate esophagitis, with efficacy similar to that of the histamine H2-receptor antagonists. H2-receptor antagonists exhibit moderate inhibition of gastric acid secretion and are effective for resolving symptoms and healing mild-to-moderate esophagitis. In addition, H2-receptor antagonists slightly augment the therapeutic efficacy of cisapride for healing mild-to-moderate esophagitis. However, use of H2-receptor antagonists at higher doses and higher frequency approaches the efficacy of proton pump inhibitors in healing erosive esophagitis. Given their potent and long-lasting acid-reducing efficacy, proton pump inhibitors have become the drugs of choice for many patients with GERD. Despite progress in the medical treatment of GERD, there are still several unresolved questions relating to cost-effective strategies with specific drugs, how long pharmacologic therapy should be maintained, and when surgical intervention is warranted. Additional studies are clearly needed to address the unresolved treatment issues in GERD. SN - 1048-9886 UR - https://www.unboundmedicine.com/medline/citation/10826019/Gastroesophageal_reflux_disease:_pathophysiology_and_pharmacology_overview_ L2 - http://www.diseaseinfosearch.org/result/2996 DB - PRIME DP - Unbound Medicine ER -