The treatment of GERD aims to control symptoms, cure esophagitis, reduce recurrence and prevent complications. (I) General treatment Change lifestyle and diet. To reduce recumbency and nocturnal reflux, the head of the bed can be elevated by 15-20 cm. Avoid eating within 2 hours before bedtime, and do not lie in bed immediately after eating during the day. Pay attention to reduce all factors that cause increased abdominal pressure, such as obesity, constipation, tight girdle, etc. Avoid eating foods that lower LES pressure, such as high fat, chocolate, coffee, strong tea, etc. Smoking and alcohol should be abstained from. Avoid applying drugs that lower LES pressure and drugs that cause delayed gastric emptying. For example, some elderly patients are prone to gastroesophageal reflux due to LES decompensation, and taking nitroglycerin preparations or calcium antagonists may aggravate reflux symptoms if they are combined with cardiovascular diseases, so they should be avoided. Some bronchial asthma patients with combined GERD may aggravate or induce asthma symptoms, so avoid the use of theophylline and dopamine agonists as much as possible and add anti-reflux treatment. (B) Drug therapy Commonly used drugs for the treatment of this disease are: 1, pro-gastrointestinal dynamics drugs such as domperidone, mosapride, etopride, etc. These drugs may be used to increase the LES pressure, improve the peristaltic function of the esophagus, promote gastric emptying, so as to reduce the reflux of gastric contents esophagus and reduce its adjuvant therapy in the esophagus. 2, acid suppressant drugs (1) H2 receptor antagonist (H2 receptor
H2RA can reduce 24-hour gastric acid secretion by 50% to 70%, but cannot effectively inhibit gastric acid secretion caused by feeding stimulation, so it is suitable for patients with mild to moderate disease. It can be used as a regular dosage for peptic ulcer, but it should be taken in divided doses, and increasing the dosage can improve the efficacy, but also increase the adverse effects. The course of treatment is 8-12 weeks. (2)Proton pump inhibitor (PPI): PPI can be used for the treatment of peptic ulcer.
inhibitor, PPI): including omeprazole, lansoprazole, pantoprazole, rabeprazole and esomeprazole. These drugs have a strong acid-suppressive effect and are therefore more effective than H2RA for this disease, especially for patients with severe symptoms and esophagitis. Generally, the dosage is as usual for the treatment of peptic ulcer, and the course of treatment is 4-8 weeks. The dosage can be doubled or combined with gastrointestinal stimulants for individual patients with poor efficacy, and the course of treatment can be extended appropriately. (3) Antacids are only used for patients with mild symptoms and intermittent attacks as a temporary relief of symptoms.
Acid suppression therapy is currently the main measure for the treatment of this disease. For patients who are receiving treatment for the first time or who have esophagitis, it is appropriate to treat them with PPI in order to rapidly control symptoms and cure esophagitis.