GASTROESOPHAGEAL REFLUX DISEASE THERAPY

Gastroesophageal reflux is a common disease. Its chronic course, even if mild, is sometimes complicated by erosive oesophagitis. Drug therap y acta against gastric acidity and motility disorders. Treatment of ga stroesophageal reflex disease has three aims: improvement of symptoms and quality of life, healing erosive lesions and preventive of symptom atic and endoscopic relapses. Non-drug measures are always useful, eve n if their efficacy is not well established. Initial therapy of a symp tomatic reflex or mild oesophagitis is most of the time effect (antaci ds, prokinetics, H-2 receptor antagonists). Proton-pump inhibitors are also effective in healing and preventing severe oesophagitis. Questio ns about long-term treatment adverse events with powerful acid inhibit ors, such as hypergastrinemia and the risk of gastric carcinold tumour s seem to be resolved. Studies are requested to define the optimal lon g-term maintenance treatment with cisapride. H-2 receptor antagonists or proton-pump inhibitors at low doses in prevention of symptomatic an d mild oesophagitis relapses.