The goals of treatment of GERD are to :
- Relieve symtoms
- Heal oesophagitis
- Maintain remmision
- Improve quality of life
- Prevent complications
Medication the have been used to relive GERD include antacids, prokinetic agent, histamine 2 resceptor antagonist (H2RA) and PPIs. PPIs are the most effective treatment for control of symptoms and healing of oesohagitis and erosive GERD.
While antacids are use for treatment of GERD, ther is only one out of three studies that shows evidence of antacid efficacy in relieving GERD symtoms. H2RA are mos effective than placebo for relieving mild to moderate GERD symtoms with a response rate between 60% to 70%.
Short term trials using PPIs have shown faster healing raes and more complete heart burn relief than H2RA of prokinetics in patiens with erosive GERD. Amongst the PPIs, standar doses have resulted in comparable helaing and remission rates in erosive oesophagitis. For NERDthe PPIs are also significantly superior to prokinetic agents in heartburn remission and to H2RA in overall symptom improvement. However they have a lower efficacy (10% - 30% less) in NERD patients than in patients with erosive GERD.
