Short term relief of acid reflux symptoms is easy. The problem is that the disease relapses, and many sufferers will require long term management.
There are general considerations that should be applied. These include: reducing acid, enhancing esophageal clearance and correcting anatomical or physiological defects.
Antacids are used for short term relieve only. H2 blockers are also effective. Proton pump inhibitors have become the mainstay in acid reflux treatment. They could be used effectively for continuous therapy in complicated cases.
Enhancing clearance and promoting mucosal defense could be attempted by such drugs as: Prokinetics, Alginates, Antacids and Mucosal protectants. These trials are practically not convincing.
Correcting anatomical or physiological defects as Hiatal Henia and lower esophageal sphincter incompetence should be considered following diagnosis of these problems. The commonly used operation is Fundoplication. The hernia is reduced, the normal position of the sphincter is restored and consequently lower esophageal sphincter competence is reinforced. However, some complications may follow this operation such as difficulty in swallowing and inability to belch or vomit. The results would be much better with good selection of patients.
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