Optimizing symptom relief and preventing complications in adults with gastro-oesophageal reflux disease.

Abstract:

:Gastro-oesophageal reflux disease (GORD) is a chronic illness causing recurrent typical and atypical symptoms. Possible complications include oesophagitis, ulcer, stricture and Barrett's oesophagus. Evidence suggests that the intraoesophageal pH correlates directly with the degree of mucosal injury. Proton pump inhibitors (PPIs) are the first choice of therapy because they are significantly more effective than histamine-2-receptor antagonists (H(2)RAs) in achieving and sustaining an intragastric pH above 4.0. Numerous trials have shown that PPIs provide superior and faster relief of heartburn compared with H(2)RAs. PPIs have also been shown to be superior to H(2)RAs in healing oesophageal ulcers and improving the clinical outcome of patients with stricture formation. Unfortunately, even higher-than-standard doses of PPIs do not provide a complete regression in the length of Barrett's oesophagus, which is the most serious complication of GORD. Although the majority of patients with oesophagitis relapse within 6 months of stopping PPI therapy, maintenance PPI therapy prevents this in more than 80% of cases. Surgical and endoscopic procedures are alternative approaches to managing GORD. Surgery is successful but is not without risk. Endoscopic procedures are promising, but comparative and longer-term efficacy and safety data are needed.

journal_name

Digestion

journal_title

Digestion

authors

Savarino V,Dulbecco P

doi

10.1159/000076371

subject

Has Abstract

pub_date

2004-01-01 00:00:00

pages

9-16

eissn

0012-2823

issn

1421-9867

pii

76371

journal_volume

69 Suppl 1

pub_type

杂志文章,评审
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    pub_type: 杂志文章,随机对照试验

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    authors: Weaver GA,Franck CA,Harris MD,Peters T Jr

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    pub_type: 杂志文章,评审

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  • Differential distribution of serotonin and tryptophan hydroxylase in the human gastrointestinal tract.

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    journal_title:Digestion

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    doi:10.1159/000007590

    authors: Meyer T,Brinck U

    更新日期:1999-01-01 00:00:00

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    pub_type: 杂志文章

    doi:10.1159/000198069

    authors: Simon B,Kather H

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    authors: Budillon G,Parrilli G,Capuano G,Mazzacca G,Menzies IS

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  • Effectiveness of Chemoradiotherapy for Metachronous Esophageal Squamous Cell Carcinoma.

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    authors: Eade OE,Maddison A,Leonard PJ,Wright R

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    pub_type: 杂志文章,评审

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    authors: McMahon MJ

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    pub_type: 临床试验,杂志文章

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    pub_type: 杂志文章

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    pub_type: 杂志文章,评审

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