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Reflux esophagitis.

Abstract

The various therapeutic approaches for reflux esophagitis are to increase the competence of the antireflux barrier, to enhance esophageal clearance, to improve gastric emptying and pyloric sphincter competence, to coat damaged tissue, and, especially, to reduce the volume and pH of gastric contents. Of the prokinetic agents, cisapride is the only drug with proven benefit. Single-agent therapy with conventional-dose H2-receptor antagonists or sucralfate results in similar degrees of symptom relief and healing. Post-evening meal (PEM) dosing of H2-receptor antagonists appears to be a rational method of suppressing late evening gastric acidity, but on balance the symptomatic response of twice daily dosing is superior to once daily dosing. More rapid symptom relief and healing are achieved with high-dose H2-receptor antagonists and omeprazole. The significance of sustained a(hypo)chlorhydria remains to be established. To prolong the symptomatic and/or endoscopic remission, the therapy has to be continued long-term with high-dose H2-receptor antagonist, cisapride either alone or in combination with H2-receptor antagonist, or sucralfate with or without H2-receptor antagonist. In the elderly or complicated patient long-term omeprazole may be a justified alternative.

Authors+Show Affiliations

Gastroenterology Dept., University of Amsterdam, The Netherlands.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

1978403

Citation

Tytgat, G N., et al. "Reflux Esophagitis." Scandinavian Journal of Gastroenterology. Supplement, vol. 175, 1990, pp. 1-12.
Tytgat GN, Nio CY, Schotborgh RH. Reflux esophagitis. Scand J Gastroenterol Suppl. 1990;175:1-12.
Tytgat, G. N., Nio, C. Y., & Schotborgh, R. H. (1990). Reflux esophagitis. Scandinavian Journal of Gastroenterology. Supplement, 175, pp. 1-12.
Tytgat GN, Nio CY, Schotborgh RH. Reflux Esophagitis. Scand J Gastroenterol Suppl. 1990;175:1-12. PubMed PMID: 1978403.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reflux esophagitis. AU - Tytgat,G N, AU - Nio,C Y, AU - Schotborgh,R H, PY - 1990/1/1/pubmed PY - 1990/1/1/medline PY - 1990/1/1/entrez SP - 1 EP - 12 JF - Scandinavian journal of gastroenterology. Supplement JO - Scand. J. Gastroenterol. Suppl. VL - 175 N2 - The various therapeutic approaches for reflux esophagitis are to increase the competence of the antireflux barrier, to enhance esophageal clearance, to improve gastric emptying and pyloric sphincter competence, to coat damaged tissue, and, especially, to reduce the volume and pH of gastric contents. Of the prokinetic agents, cisapride is the only drug with proven benefit. Single-agent therapy with conventional-dose H2-receptor antagonists or sucralfate results in similar degrees of symptom relief and healing. Post-evening meal (PEM) dosing of H2-receptor antagonists appears to be a rational method of suppressing late evening gastric acidity, but on balance the symptomatic response of twice daily dosing is superior to once daily dosing. More rapid symptom relief and healing are achieved with high-dose H2-receptor antagonists and omeprazole. The significance of sustained a(hypo)chlorhydria remains to be established. To prolong the symptomatic and/or endoscopic remission, the therapy has to be continued long-term with high-dose H2-receptor antagonist, cisapride either alone or in combination with H2-receptor antagonist, or sucralfate with or without H2-receptor antagonist. In the elderly or complicated patient long-term omeprazole may be a justified alternative. SN - 0085-5928 UR - https://www.unboundmedicine.com/medline/citation/1978403/Reflux_esophagitis_ DB - PRIME DP - Unbound Medicine ER -