Gastroesophageal reflux disease (GERD) is a chronic, recurring, multisymptomatic disease caused by spontaneous, regularly repeated gastric and/or duodenal contents into the esophagus, leading to a lesion of the lower esophagus.
The basis of treatment is a lifestyle change – normalization of body weight, elimination of smoking, reducing consumption of alcohol, fatty foods, coffee, chocolate, carbonated drinks, food should be taken in small portions, regularly, supper no later than 2-3 hours before bedtime, eliminate the burden associated with increasing intra-abdominal pressure, as well as wearing tight belts. Sleep is recommended with an elevated position of the head end of the bed.
For the treatment of GERD, the following groups of drugs are used: prokinetics, H2 blockers and proton pump inhibitors. Prokinetics, such as metoclopramide (cerucal), are primarily designed to accelerate the emptying of the stomach.
Zantac (ranitidine) Metoclopramide is not prescribed as the only drug for GERD, but only as an adjunct to other antireflux medications in patients with gastroparesis. The drug may cause neurological side effects, which may not disappear after discontinuation of the drug.
H2-blockers (famotidine, cimetidine, ranitidine, nizatidine) reduce the amount of acid produced in the stomach. In prescription doses, they eliminate symptoms and cure the esophagus in about 50% of patients. Nevertheless, only 25% of patients using H2-blockers remain in remission.
Inhibitors of the proton pump inhibit the secretion of acid in the stomach. They allow you to quickly get rid of the symptoms and heal the esophagus in 80-90% of patients. These drugs are also useful in the treatment of strictures, one of the most serious complications of GERD. They are more effective than H2-blockers in reducing acid secretion.