title: Mucosal Protective Compounds in the Treatment of Gastroesophageal Reflux Disease. A Position Paper Based on Evidence of the Romanian Society of Neurogastroenterology.
abstract: OBJECTIVE
  Gastroesophageal reflux disease (GERD) therapy is challenging and suppression of acid secretion or prokinetics do not cure all cases. Some drugs with protective action on the esophageal mucosa have been used alternatively or in association with proton pump inhibitors (PPIs) and/or prokinetics. The Romanian Society of Neurogastroenterology undertook an Evidence-Based analysis, from which this position paper evolved.
  
  
  METHODS
  We performed a systematic literature search in PubMed until October 2015, using the terms: sucralfate, guaiazulene, gaiazulene, dimethicone, alginate, antacids and gastroesophageal reflux. Forty-seven papers were included and analyzed. Several statements were elaborated regarding the use of these drugs in GERD. The evidence and recommendations were discussed between the authors.
  
  
  RESULTS
  There is evidence in the medical literature suggesting the benefit of these drugs in GERD. In patients with persistent or mild reflux symptoms antacids rapidly relieve heartburn. Alginate-antacid combination is superior both over placebo and antacids to treat mild reflux symptoms, and can be used to treat persistent reflux symptoms despite acid suppressant therapy. Sucralfate is superior over placebo in alleviating GERD symptoms and can be used as maintenance therapy. Guaiazulene-dimethicone improves the quality of life in patients with GERD.
  
  
  CONCLUSIONS
  Drugs used to protect the esophageal mucosa against acid are useful in alleviating chronic heartburn, especially in patients with mild reflux symptoms.
authors.affiliation: 2nd Medical Department, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Teodora
authors.initials: T
authors.lastname: Surdea-Blaga
authors.affiliation: Fundeni Clinical Institute, Bucharest, Romania.
authors.forename: Ion
authors.initials: I
authors.lastname: Băncilă
authors.affiliation: Gastroenterology Department, University of Medicine and Pharmacy, Târgu Mureș, Romania.
authors.forename: Daniela
authors.initials: D
authors.lastname: Dobru
authors.affiliation: Institute of Gastroenterology and Hepatology, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania.
authors.forename: Vasile
authors.initials: V
authors.lastname: Drug
authors.affiliation: Department of Internal Medicine, Emergency Clinical County Hospital, University of Oradea, Oradea, Romania.
authors.forename: Ovidiu
authors.initials: O
authors.lastname: Frățilă
authors.affiliation: Gastroenterology and Hepatology Department, Victor Babeș University of Medicine and Pharmacy, Timișoara, Romania.
authors.forename: Adrian
authors.initials: A
authors.lastname: Goldiș
authors.affiliation: 2nd Medical Department, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Simona M
authors.initials: SM
authors.lastname: Grad
authors.affiliation: 2nd Medical Department, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Crina
authors.initials: C
authors.lastname: Mureșan
authors.affiliation: Faculty of Medicine, Transylvania University, Brașov, Romania.
authors.forename: Laurențiu
authors.initials: L
authors.lastname: Nedelcu
authors.affiliation: Medical Department, County Emergency Hospital, Sibiu, Romania.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Porr
authors.affiliation: Gastroenterology and Hepatology Department, Victor Babeș University of Medicine and Pharmacy, Timișoara, Romania.
authors.forename: Ioan
authors.initials: I
authors.lastname: Sporea
authors.affiliation: 2nd Medical Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Dan L
authors.initials: DL
authors.lastname: Dumitrascu
mesh_terms: D000464:Alginates / Q000627:therapeutic use; D000863:Antacids / Q000009:adverse effects / Q000627:therapeutic use*; D032921:Consensus; D019610:Cytoprotection; D004129:Dimethylpolysiloxanes / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D000071041:Esophageal Mucosa / Q000187:drug effects* / Q000473:pathology; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D018579:Patient Selection; D020011:Protective Agents / Q000009:adverse effects / Q000627:therapeutic use*; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D012720:Severity of Illness Index; D013392:Sucralfate / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000464:Alginates; D000863:Antacids; D004129:Dimethylpolysiloxanes; D020011:Protective Agents; D054328:Proton Pump Inhibitors; D013392:Sucralfate; C501844:dimethicone