| Theme |
GERD in Clinical Practice 2018 -- Current Status and Issues |
| Title |
Treatment of GERD |
| Author |
Tadayuki Oshima |
Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine |
| Author |
Toshihiko Tomita |
Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine |
| Author |
Yoshio Ohda |
Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine |
| Author |
Hirokazu Fukui |
Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine |
| Author |
Jiro Watari |
Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine |
| Author |
Hiroto Miwa |
Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine |
| [ Summary ] |
Gastroesophageal reflux disease (GERD) is defined as a condition in which gastroesophageal reflux (GER) causes either esophageal mucosal breaks or annoying symptoms including heartburn and regurgitation, or both. Lifestyle modification and medical treatments are the primary treatment strategies employed for the management of GERD. Lifestyle modification is an effective strategy, although the evidence level is not so high with respect to each factor. Alginate, histamine H2 receptor antagonists (H2RAs), proton‒pump inhibitors (PPIs), and potassium‒competitive acid blockers (P‒CABs) form useful components of the medical treatment regimen for GERD, and mucosal healing and symptom relief are the primary endpoint of such treatment. PPIs and P‒CABs are the primary agents with alginate used as a supplemental medicine in patients who develop symptoms even with the administration of PPIs, to achieve esophageal mucosal healing and symptomatic treatment. Treatment of PPI‒refractory GERD might require the administration of high doses of PPIs (double doses) or switching to P‒CABs for symptom relief and esophageal mucosal healing. |