Gastroesophageal reflux disease[GERD]is a fairly common disorder marked by backflow of gastric or duodenal contents into the esophagus that causes troublesome symptoms and /or mucosal injury to the esophagus.

Medical management of GERD

The first step in treatment is to teach the patient how to avoid situations that cause esophageal irritation or lower esophageal sphincter pressure to drop. Eat a fat-free diet, avoid caffeine, tobacco, beer, milk, peppermint or spearmint items, and carbonated beverages two hours before night, keep normal body weight, avoid tight-fitting clothing, and raise the head of the bed about 30 degrees.

If the medical management is unsuccessful, surgical intervention may be necessary.

Pharmacological Management of GERD

Antacids/Acid Neutralizing agents

• Calcium carbonate
• Aluminum hydroxide, magnesium hydroxide, semithicone[Maalox]

Histamin-2[H2]receptor antagonists

• Famotidine [Pepcid]
• Ranitidine [Zantac]
• Cimetidine[Tagamet]

Prokinetic agents

• Metoclopramide[Reglan]

Proton pump inhibitors

• Pantoprazole[Protonix]
• Omeprazole[Prilosec]
• Esomeprazole[Nexium]
• Lansoprazole[Prevacid]
• RAbeprazole[AcipHex]
• Dexlansoprazole[Dexilant]

Reflux inhibitors

• Bethanechol chloride[Ureholine]

Surface Agents/Alginate-based barriers

• Sucralfate