GERD management
GERD Management
Gastro esophageal reflux disease (GERD) is the most common out-patient gastroenterology diagnosis in the United States, with a prevalence of 10% to 20% in the Western world and an annual incidence of 0.38% to 0.45%. In the United States,
20% of the adult population experiences GERD-related symptoms weekly and 7% daily. Erosive esophagi is accounts for up to 30% of the GERD population, while non-erosive reflux disease (NERD) can affect up to 70% of these patients. GERD reduces health-related quality of life and imposes a significant economic burden on the health care system. Acid suppression is the mainstay of therapy for GERD. The development of proton pump inhibitors (PPIs), which reduce gastric acid secretion through blockade of the active H /K ATPase (proton pump), has revolutionized the treatment of GERD.
Generally, PPIs are a safe class of drugs that provide symptomatic relief and achieve healing of esophageal mucosa in the majority patients with erosive esophagus. Moreover, PPIs have been shown to improve the quality of life of GERD patients.
Despite the success that PPIs have achieved in treating GERD and GERD-related complications, unmet needs and significant challenges remain. Specially, approximately 10% – 15% of adult patients with erosive esophagus fail to achieve complete healing after 8 weeks of treatment. This subset of patients usually demonstrate moderate to severe disease (Los Angeles grades C and D) and comprise approximately 25% – 30% of all erosive esophagus patients (8). Moreover, even when continuing the initial healing dose, 15% – 23% of adult patients with Los Angeles grades A and B and 24% – 41% with grades C and D relapse within 6 months. In addition, up to 40% of non-erosive reflux disease (NERD) adult patients remain
Gastro esophageal reflux disease (GERD) is the most common out-patient gastroenterology diagnosis in the United States, with a prevalence of 10% to 20% in the Western world and an annual incidence of 0.38% to 0.45%. In the United States,
20% of the adult population experiences GERD-related symptoms weekly and 7% daily. Erosive esophagi is accounts for up to 30% of the GERD population, while non-erosive reflux disease (NERD) can affect up to 70% of these patients. GERD reduces health-related quality of life and imposes a significant economic burden on the health care system. Acid suppression is the mainstay of therapy for GERD. The development of proton pump inhibitors (PPIs), which reduce gastric acid secretion through blockade of the active H /K ATPase (proton pump), has revolutionized the treatment of GERD.
Generally, PPIs are a safe class of drugs that provide symptomatic relief and achieve healing of esophageal mucosa in the majority patients with erosive esophagus. Moreover, PPIs have been shown to improve the quality of life of GERD patients.
Despite the success that PPIs have achieved in treating GERD and GERD-related complications, unmet needs and significant challenges remain. Specially, approximately 10% – 15% of adult patients with erosive esophagus fail to achieve complete healing after 8 weeks of treatment. This subset of patients usually demonstrate moderate to severe disease (Los Angeles grades C and D) and comprise approximately 25% – 30% of all erosive esophagus patients (8). Moreover, even when continuing the initial healing dose, 15% – 23% of adult patients with Los Angeles grades A and B and 24% – 41% with grades C and D relapse within 6 months. In addition, up to 40% of non-erosive reflux disease (NERD) adult patients remain