New Treatments For GERD 2022

GERD

GERD is a chronic gastrointestinal disease that occurs when the lower esophageal sphincter (LES) does not close properly and stomach contents rise up into the esophagus. Symptoms include heartburn, regurgitation of acidic liquid, and chest pain.

GERD also can cause other, extraesophageal symptoms such as hoarseness, throat clearing, asthma, and laryngitis. These symptoms can be difficult to distinguish from those caused by GERD, so multidisciplinary evaluation is essential.

 

Medications

GERD can be treated with medications that suppress acid production and heal the esophagus. These include histamine receptor antagonists (H2 blockers) and proton pump inhibitors.

Medications for GERD are usually prescribed by a doctor. These medications are designed to prevent stomach contents from flowing back up into the esophagus and to treat heartburn, regurgitation, and other symptoms.

These include over-the-counter (OTC) antacids and prescription-strength proton pump inhibitors. Nonprescription H2 blockers include cimetidine and famotidine, as well as nonsteroidal anti-inflammatory drugs (NSAIDs).

Prescription-strength proton pump inhibitors, which include pantoprazole, omeprazole, lansoprazole, and rabeprazole, are the preferred agents for initial GERD therapy and maintenance in patients with healed erosive GERD.

PPIs are also the first line of treatment for refractory GERD. However, they may have side effects, such as diarrhea, headaches, and nausea, which are often severe enough to cause problems with eating or drinking. In addition, gastrointestinal tract infections, low vitamin B-12 or magnesium levels, and hepatic disorders have been reported to occur in some people who take these medications.

Lifestyle Modifications

GERD is a common gastrointestinal disorder that can be treated with medications, medical therapy, or surgery. It occurs when stomach acid backs up into the esophagus. It can cause heartburn, regurgitation, or pain.

Lifestyle modification is a key treatment strategy that can often relieve symptoms. These strategies include changing your diet to reduce the amount of fatty or fried food, spicy foods, alcoholic drinks, carbonated beverages, and coffee. They also include changing your sleeping position and losing weight if you are overweight.

Studies on adherence to lifestyle recommendations for GERD management are scarce. This is likely due to a lack of standardized guidelines for dietary or sleep recommendations, as well as a general lack of health literacy among patients with GERD.

Medical Therapy

GERD is a chronic disorder that occurs when the stomach contents backflow into the esophagus, causing reflux symptoms and GERD complications. Treatment for GERD involves various lifestyle and medical interventions that have been shown to be effective in managing the condition.

The first step in the management of GERD is to avoid acid-producing foods and beverages. Other diet modifications such as reducing spicy foods, caffeine, chocolate, and tobacco are also recommended.

Another approach to managing GERD is the use of medicines that suppress acid production in the stomach. This may be done by antacids, histamine receptor antagonists (H2 blockers), proton pump inhibitors (PPIs), or other drugs.

Currently, the mainstay of medical therapy for GERD is PPIs. However, there are many unmet needs in this area of medicine and drug development is being pursued to address them. Some of these newer compounds include gamma-aminobutyric acid type-B (GABA-B) receptor agonists, cholecystokinin antagonists, and potassium competitive acid blockers as add-on drugs to PPIs.

Surgical Therapy

GERD is a complex condition, and many factors contribute to its development. There are modifiable (lifestyle, eating habits) and non-modifiable (age, gender, sex, genetics) components.

There are many options for the treatment of GERD, including medication and surgical therapy. For some patients, a combination of medication and lifestyle modifications works well.

Other patients do not find relief from these methods, and surgery may be necessary. Depending on your symptoms and response to treatment, your doctor will decide what is best for you.

For patients who have refractory GERD, fundoplication is a standard procedure that can be performed laparoscopically. However, there are newer, less invasive techniques that can be considered in appropriate patients.

Some of these new techniques include injectable polymers to tighten the lower esophageal sphincter, anti-reflux mucosectomy, radio-frequency ablation, endoscopic suturing devices, and electrical stimulation of the lower esophageal ring. A few of these techniques can be done through the mouth, such as a transoral incisionless fundoplication (TIF). These procedures have been shown to reduce TLESRs and esophagogastric junction distensibility.

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