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Medical Therapy for GERD

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Antireflux Surgery

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Abstract

Medical treatment of gastroesophageal reflux disease (GERD) involves the discussion of diet, lifestyle, and appropriate use of antisecretory medications. Decreasing troublesome symptoms, augmenting quality of life, and reducing complications are the primary goals of medical treatment. Understanding the pharmacology of the available agents and their efficacy is paramount for effective intervention. Better understanding of the potential side effects of proton pump inhibitors is emerging and requires understanding.

The therapy of GERD should be individualized to obtain the optimal results for each patient. The clinician should use the available treatments with the goal of achieving complete symptom relief and improvement of quality of life. Prevention of complications and the healing of mucosal lesions are secondary, but often important, goals. Delaying progression and/or preventing malignancy in patients, related to Barrett’s esophagus is a goal we all hope to achieve one day.

The “menu” available to clinicians includes lifestyle modifications, antacids, mucosal protectants, prokinetic (promotility) agents, H2 receptor antagonists (H2RAs), and the current agents of choice—proton pump inhibitors (PPIs). Each will be discussed in the context of a general approach to acute and long-term medical therapy. Specific clinical situations are addressed throughout the chapter.

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Authors and Affiliations

  1. Division of Gastroenterology, Department of Medicine, Einstein Medical Center, 5401 Old York Road, Klein Professional Building, Suite 363, Philadelphia, PA, 19141, USA

    Philip O. Katz MD

  2. Department of Medicine, Einstein Medical Center, 5401 Old York Road, Klein Professional Building, Suite 363, Philadelphia, PA, 19141, USA

    Jorge R. Uribe MD

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Correspondence to Philip O. Katz MD .

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Editors and Affiliations

  1. GI and MIS Surgery, The Oregon Clinic Providence Portland Medical Center, Portland, Oregon, USA

    Lee L. Swanstrom

  2. GI and MIS Surgery, The Oregon Clinic Providence Portland Medical Center, Portland, Oregon, USA

    Christy M. Dunst

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Katz, P.O., Uribe, J.R. (2015). Medical Therapy for GERD. In: Swanstrom, L., Dunst, C. (eds) Antireflux Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1749-5_4

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