title: Medical treatments of GERD: the old and new.
abstract: The mainstay of pharmacological therapy for GERD is gastric acid suppression with proton pump inhibitors (PPIs), which are superior to histamine-2 receptor antagonists for healing erosive esophagitis and achieving symptomatic relief. However, up to one-third of patients may not respond to PPI therapy, creating the need for alternative treatments. Potential approaches include transient lower esophageal sphincter relaxation inhibitors, augmentation esophageal defense mechanisms by improving esophageal clearance or enhancing epithelial repair, and modulation of sensory pathways responsible for GERD symptoms. This review discusses the effectiveness of acid suppression and the data on alternative pharmacological approaches for the treatment of GERD.
authors: Division of Gastroenterology and Hepatology, Michael E. DeBakey VA Medical Center, Baylor College of Medicine, 2002 Holcombe Boulevard, Houston, TX 77030, USA. Electronic address: mvela@bcm.edu.
authors: Marcelo F
authors: MF
authors: Vela
mesh_terms: D000700:Analgesics / Q000627:therapeutic use; D000863:Antacids / Q000627:therapeutic use; D001562:Benzimidazoles / Q000627:therapeutic use; D058786:GABA-B Receptor Agonists / Q000627:therapeutic use; D005764:Gastroesophageal Reflux / Q000188:drug therapy*; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D064529:Receptor, Metabotropic Glutamate 5 / Q000037:antagonists & inhibitors
chemical_list: C574562:AZD1386; D000700:Analgesics; D000863:Antacids; D001562:Benzimidazoles; D058786:GABA-B Receptor Agonists; D005765:Gastrointestinal Agents; D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors; D064529:Receptor, Metabotropic Glutamate 5
keywords: Esophageal mucosal repair; Gastroesophageal reflux; Prokinetics; Proton pump inhibitors; Transient lower esophageal sphincter relaxation inhibitors; Visceral analgesia