GIT - GERD

14 important questions on GIT - GERD

What is the role of Sucralfate in the drug therapy of GERD?

Sucralfate produces symptom relief and esophageal healing only in mild or moderate cases or in combination therapy.

What are acid-suppressive agents used for in GERD therapy?

Acid-suppressive agents are the most effective means for symptom relief and healing of esophagitis in GERD therapy. They include Proton-Pump inhibitors and Histamine H2 Receptor Antagonists.

What do alginate-containing antacids do in the treatment of GERD?

Alginate-containing antacids neutralize HCL and form an anti-reflux layer over gastric material, leading to symptom relief. They are effective mainly in combination with other drugs.
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What are Proton-Pump inhibitors and their role in GERD therapy?

Proton-Pump inhibitors (e.g. Esomeprazole, Omeprazole, Pantoprazole) have higher healing rates but require lifestyle modification and can be combined with Prokinetics in GERD therapy.

What drugs should be avoided to prevent increased HCL effects?

Avoid drugs that contribute to effects/increase HCL, such as NSAIDs and Corticosteroids. These can exacerbate symptoms by increasing stomach acid production.

How do prokinetic drugs help in GERD treatment?

Prokinetic drugs increase gastric motility and emptying. They improve LES tone and esophageal motility, decrease reflux, and improve luminal clearance. They provide symptom relief and esophageal healing in mild or moderate cases.

How do Histamine H2 Receptor Antagonists function in GERD therapy?

Histamine H2 Receptor Antagonists (e.g. Ranitidine, Famotidine, Cimetidine) have healing rates less than in PUD. They are given in higher and more frequent doses with prokinetic drugs.

What are some lifestyle modifications to delay GERD recurrence?

  • Remaining upright for 2 hours after meals
  • Elevation of head during sleep
  • Decrease meal portion size
  • Reduce body weight

What are examples of direct mucosal irritants to avoid?

Avoid direct mucosal irritants like citric acid and cigarette smoking. These substances can irritate the mucosal lining and worsen symptoms.

In what cases are prokinetic drugs effective for symptom relief and esophageal healing?

Prokinetic drugs produce symptom relief and esophageal healing only in mild or moderate cases or in combination with other drugs.

What are the therapeutic goals in GERD?

The therapeutic goals in GERD include:
  • Symptom relief
  • Healing of esophagitis
  • Prevention of complications

Which foods should be avoided due to their effect on esophageal sphincter pressure?

Avoid foods that lower esophageal sphincter pressure (LESP) such as fatty foods, coffee, chocolate, and spicy food. These can decrease LESP and worsen symptoms.

What are the approaches to treatment for GERD?

Approaches to treatment for GERD include:
  • Non-pharmacological (Life-style modification)
  • Pharmacological (Drugs)

What types of drugs can lower LESP and should be avoided?

Avoid drugs that lower LESP, including Anticholinergics, TCAs, Nitrates, CCBs, β2-agonists, α-adrenoceptor blockers, Alcohol, and Caffeine. These can reduce LESP and exacerbate symptoms.

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