Publication details
Refluxní choroba jícnu
| Title in English | Gastroesophageal reflux disease |
|---|---|
| Authors | |
| Year of publication | 2013 |
| Type | Article in Periodical |
| Magazine / Source | Medicína po promoci |
| MU Faculty or unit | |
| Citation | |
| Field | Other specializations of internal medicine |
| Keywords | gastroesophageal reflux disease; esophagitis; H2-blockers; proton pump inhibitors; prokinetics |
| Description | Gastroesophageal reflux disease (GERD) has a significant impact on the patients’ quality of life, it can be accompanied by many severe complications and is associated with an increased risk of esophageal cancer. The evaluation of this disease consists mainly of invasive endoscopic examination performed to assess the mucosal lesions and to solve potential differential diagnostic problems, of 24-hour esophageal pH monitoring, esophageal impedance measurement and of esophageal manometry; all these investigations, however, should be preceded by appropriate history taking. Proton pump inhibitors are the most effective drugs for the therapy of reflux esophagitis. This applies especially to so called 2nd generation drugs like esomeprazole or rabeprazole. All proton pump inhibitors are clearly more effective than H2-blockers. The effect of prokinetics is not unequivocal; in some situations, though, they can potentiate the impact of therapy with proton pump inhibitors (this finding being consistent with personal experience of the authors). The treatment must always be initiated with a sufficient dose of the selected drug(s). Long-term therapy has to be expected, followed by maintenance treatment. On-demand therapy represents an alternative. |