How to treat reflux esophagitis: the most effective drugs

Reflux esophagitis is common enough in modern humans the disease. It is characterized by pathological periodic ejection of stomach contents back into the esophagus, which causes irritation, inflammation and errosive processes.

Modern gastroenterology has developed some of the most effective courses of treatment in several stages, which successfully help to cope with unpleasant symptoms and eliminate the cause of disease.

Basic principles of drug therapy

Depending on the stage of the pathology, the following standardized courses of treatment:

1. Erosive stage. At this stage, medical therapy is used for 2 months. Proton pump inhibitors, which suppress further production of hydrochloric acid in the stomach, apply twice a day.
2. Non-erosive stage. Because injury to the esophagus is substantially smaller, the course of treatment is shorter by a month than in the case of erosive stages of the disease. Proton pump inhibitors are used only 1 time per day. Dose picked depending on the intensity of acid discharge.

During the course of treatment is additionally prescribed prokineticakimi means for normalizing the motility of the gastrointestinal tract, as well as antacids to reduce the concentration of hydrochloric acid of the stomach. It stimulates the restoration of normal work of the digestive system and does not break down cells and tissues of the mucous membranes of the stomach, esophagus and intestines.

Later these drugs are used as maintenance therapy to reduce the risk of remission of the pathological process.

In cases when the condition is chronic or there is the risk of esophageal cancer, the drug for maintenance therapy is taken for life.

How to treat reflux esophagitis

The duration of the course of drug therapy and dose selected pharmacological agents can pick up only the doctorbased on the results obtained after a thorough diagnosis of the patient.

Experts klassificeret the complexity of medication therapy across multiple treatment regimens:

• therapy with a single drug (usually prokinetic or antacid). Effective only in cases of a single problem. Not suitable for prolonged treatment of complex cases;
• growing therapy. Is the gradual addition of new drug at each stage, depending on the aggressiveness of occurrence of pathological processes. Start treatment with normalizing day regimen, dieting and monoterpenoids funds, gradually adding one of farmpreparat, if the desired therapeutic effect is not achieved;
• third circuit means receiving strong inhibitors of proton pump with the first day of treatment to the temporary blockade of the production of excessive amounts of stomach irritating hydrochloric acid. Once the severity of symptoms significantly reduced, gradually introduce prokineticakimi funds. The motility of the gastrointestinal tract accompanied by diet and avoidance of heavy physical exertion. The return to normal life is by taking antacids;
• the fourth treatment is a surgical intervention solely due to the irreversible destructive damage of the esophagus and the subsequent reparative therapy stronger drugs.

In any method of treatment of the most important stages are the neutralization of hydrochloric acid or suppressing its production by the stomach and mucous membrane regeneration after irritant corrosive substances.

Proton pump inhibitors

The use of proton pump inhibitors – based drug therapy of reflux esophagitis, especially if the problem becomes protracted and results in substantial deterioration of the body.

When reflux disease drugs often manufactured in capsules coated with soluble shells are used inside by the oral route. The absorption of active substances occurs in the gut, where the reactants into the liver, are metabolized in the secretory tubules, inhibiting their activity and preventing the formation of gastric juice. The contents of the stomach gradually becomes less aggressive, reduced the intensity of its action on mucous membranes and decreases the speed of ejection.

The principle of operation of all the proton pump inhibitors the same speed of absorption and the effects of drugs, the degree of cleaning and the duration of effectiveness. Each drug lowers acidity in the stomach depending on the dose and brand, so pick them can only specialist, with a preliminary state change of the pH of the stomach contents.

The duration of intake of proton pump inhibitors can range from 1 month to several years, depending on the course of disease and the extent of involvement of internal organs. Medications safe for the body and, characteristically, does not provoke addiction.

There are several the most popular drugs containing the same active substance:

• omeprazole (Omeprazole-Richter, Omez, Ultop, Losec, Halal) – the most simple ingredient that is used not only in oral capsules, but also intravenous drip to achieve faster results. The drug is characterized by slow activity with subsequent high efficiency. Does not provoke the recurrence of States with high acidity. Can be combined with other drugs. This helps it combination in a single drug to affect not only the level of acidity of the stomach, but also to normalize their motor skills, such has pharmacological effects the drug Omez-D.

Despite the positive actions of omeprazole, experts recommend to use products of a newer generation because they have higher clearance and ingestion significantly reduced the risk of numbness of the tissues of the gastrointestinal tract.

• pantoprazole (Nolpaza, Controloc, Sampras) is available in capsules for oral administration and in ampules for injection. With pantoprazole produced significantly fewer gastric juice and reduces the degree of irritation of the internal organs. The drug is characterized in that when it is received can even gradually heal ulcers and predjisone state;
• rabeprazol (Pariet, Rabeloc, Harbeson) is the drug of the penultimate generation. Has an extremely high efficiency and is assigned only in cases of serious pathological disorders in the gastrointestinal tract. The product is not compatible with liquid antacids, unlike other proton pump inhibitors, so after passing the acute phase of illness, it overturned, gradually move the patient on medication to decrease the acidity and normalizes motor activity of the stomach;
• lansoprazole (Lanced, Lanzap) is a drug of last generation. Can not only block the proton pump, but also affects the cause of inflammatory processes of the gastrointestinal tract – the bacteria Helicobacter Pylori. Used when reflux esophagitis, triggered by the acute stage of hyperacid gastritis or gastric ulcer. Used with caution with other drugs as their metabolites can inhibit the action of this active substance;

• esomeprazole (Emaner, Nexium, Amesol) is often used when ulcers stomach and duodenal ulcers. Appointed in reflux only in severe stages of these pathologies, complications of acid regurgitation. One of the few drugs, easy to combine with antibacterial and antimicrobial agents.

The convenient doses of these drugs are used only 1-2 times a day without causing discomfort to the patient. They have practically no contraindications except pregnancy, lactation, children’s age up to 12 years and are hypersensitive to the components of medicines.

Prokineticakimi drugs

Prokinetics are known for their ability to affect motor activity of the gastrointestinal tract. They accelerate the process of moving food through the stomach and intestines and stimulate the process of emptying. Also prokinetics are used to correct pyloric and esophageal reflux because they can affect nerve endings that control the mechanical activity of the stomach.

Depending on the mechanism of action of prokinetics are divided:

• non-selective blockers of dopamine receptors first generation: has antiemetic effect, effect on motor function of the stomach. The most commonly used drugs containing the active ingredient metoclopramide (Bromopride, Dimethenamid, Reglan). In those cases where the reflux is too strong and causes large amount of discomfort with any contact with food or medicines into the stomach, and to achieve a more rapid effect, the drug with metoclopramide for intravenous administration. Drugs are used only in severe cases the course of disease and emergency treatment, as have a large number of side effects;
• selective drugs are second-generation medicines based on domperidone (Motylek, Motilium, Motorics). Considered to be more mild and safe, be permitted in the form of syrups, even in children. Of the side effects can be noted only slight drowsiness in some patients appears weakly expressed headache. Resolve the regurgitation by acting on the receptors responsible for motor processes of the digestive tract;

• prokinetics the new generation: the group of medicines which have the composition of the active substance is itopride does hydrochloride (Itomed, Anatom, itopride does). At the moment these drugs are seeking to appoint gastroenterologists, since they have a long lasting effect and do not cause side effects. Can be applied throughout life, as it does not cause addiction and successfully manage reflux disease, even after long time continuous use.

Because prokinetics act on the nervous system, it is impossible to pick up by yourself to correct reflux disease. They do not solve the problem of the adverse effects of acid on mucous membranes, but can reduce the intensity of release and normalize motor activity of the stomach.

Antacids

Antacids are medicines that the major mechanism of action which is a significant decrease in the concentration of hydrochloric acid in the stomach by partial or complete neutralization. These drugs are considered the most secure, refer to the list of the most popular symptomatic drugs and have minimal list of side effects.

Depending on the therapeutic effect of a drug they are divided into:

• Absorbed medicines (Rennie, Tams). Penetrating the esophagus, these medications provoke almost instant decrease in acidity. The result is pain, sour belching and discomfort virtually disappear. However, their effect is rather short-lived and may cause long-term use as monotherapy reverse the release. In some cases, patients complained of weakness, headache, flatulence.
• Nonabsorbable antacids (Maalox, Nevison, aluminium phosphate gel, Gastal, Racer, Almagel) – a new generation of drugs, a lot of advantages:
  1. are manufactured in various product forms.Acute reflux is best to choose a liquid form of antacid to provide the enveloping effect.
  2. the effect is long enough, when it comes quickly;
  3. it is possible to apply pregnant women and children;
  4. does not cause side effects;
  5. eliminates the sour taste in my mouth and completely relieves dyspeptic disorder;
  6. thanks to the additional components can gently bring harmful substance, triggering an acute release of stomach acid, naturally.

Antacids are the drugs of choice for disorders of the stomach, associated with a sharp increase in the acidity level due to its fast and smooth action.