What are the treatments for gastroesophageal reflux

Many people may not know what gastroesophageal reflux is, but it is actually a manifestation or symptom of a digestive tract disease. Because gastric juice is somewhat irritating, it may cause respiratory or esophageal hepatitis. Common conditions can be alleviated and treated by taking medication.

Drug treatment

(a) H2 receptor antagonists (H2RA) such as cimetidine, ranitidine, famotidine, etc. H2RA can reduce 24-hour gastric acid secretion by 50%-70%, but cannot effectively inhibit gastric acid secretion stimulated by food. Therefore, it is suitable for patients with mild and moderate symptoms. It can be used according to the conventional dosage for the treatment of peptic ulcer, but it should be taken in divided doses. Increasing the dosage can improve the efficacy, but it will increase adverse reactions. The course of treatment is 8-12 weeks.

(ii) Prokinetic drugs: This type of drug increases LES pressure, improves esophageal motility, and promotes gastric emptying, thereby reducing esophageal reflux of gastric contents and reducing their exposure time in the esophagus. Although there are many types of drugs of this type, based on a large number of clinical research results, the drug currently recommended for the treatment of this disease is mainly cisapride. The efficacy of cisapride is similar to that of H2RA and is also suitable for patients with mild to moderate symptoms. The usual dosage is 5-15 mg each time, 3-4 times a day, and the course of treatment is 8-12 weeks.

(iii) Proton pump inhibitors (PPIs) include omeprazole, pantolazone, etc. This type of drug has a strong acid-suppressing effect, so it is more effective than H2RA or cisapride for this disease. It is particularly suitable for patients with severe symptoms and severe esophagitis. Generally, the conventional dosage for treating peptic ulcer is used, and the course of treatment is 8-12 weeks. For patients with poor therapeutic effect, the dose can be doubled or used together with cisapride.

(IV) Antacids are only used to temporarily relieve symptoms in patients with mild symptoms and intermittent attacks.

Gastroesophageal reflux disease has a tendency to chronically relapse. According to reports from Western countries, the relapse rate six months after discontinuation of medication is as high as 70%-80%. In order to reduce the recurrence of symptoms and prevent complications caused by repeated recurrence of esophagitis, it is necessary to consider maintenance treatment. Patients who relapse soon after stopping the medication and whose symptoms persist often require long-term maintenance treatment. Patients with complications of esophagitis such as esophageal ulcers, esophageal stenosis, and Barrett's esophagus definitely require long-term maintenance treatment. H2RA, cisapride, and PPI can all be used for maintenance treatment, among which PPI has the best effect. The dosage for maintenance therapy varies according to individual patients, and the optimal dosage is the lowest dose that is adjusted to the patient without symptoms.