Gastroesophageal reflux disease medical therapy
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The mainstay treatment of GERD is lifestyle modifications which include weight loss, elevating head of the bed and no eating before going sleep. The pharmacologic medical therapy is recommended among patients with persistent GERD despite following the lifestyle modifications. Antacids, histamine receptor antagonists, proton pump inhibitors, and prokinetics medications are used in treatment of GERD.
- The following measures are recommended as the first line to treat GERD:
- Weight loss
- Elevating head of the bed
- No eating two hours before going sleep
- Avoidance of the following foods and lifestyles is recommended in treatment of GERD:
- Excessive amounts of Vitamin C supplements
- Foods high in fats
- Eating shortly before bedtime
- Large meals
- Chocolate and peppermint.
- Acidic foods, such as oranges and tomatoes.
- Cruciferous vegetables such as: Onions, cabbage, cauliflower, broccoli, spinach, brussel sprouts
- Milk and milk-based products
- The medical therapy is indicated for the patients who have persistent GERD regardless the lifystyle and food modifications.
- The following medical therapies are strongly recommended by the American College of Gastroenterology:
- Histamine-receptor antagonists (H2RA):
- Proton pump inhibitors:
- Prokinetic medications:
- Preferred regimen (1): Metoclopramide 10 mg q24 PO for 4 to 12 weeks
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- Kaltenbach T, Crockett S, Gerson LB (2006). "Are lifestyle measures effective in patients with gastroesophageal reflux disease? An evidence-based approach". Arch. Intern. Med. 166 (9): 965–71. doi:10.1001/archinte.166.9.965. PMID 16682569.
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