Gastroesophageal Reflux Disease
GERD
Proton Pump Inhibitors
Omeprazole, Esomeprazole, Lansoprazole, Pantoprazole
Epidemiology:
10-12% in Western world and <5% in Asia.
Chronic digestive disease that occurs when stomach acid or, occasionally, bile refluxes into the esophagus.
Inhibits H+, K+, -ATPase transporter to decrease acid production by parietal cells.
Risk Factors
Not very many common SEs - primarily GI based
Concerning SEs includes rhabdomyolysis and increased risk of bone fracture
Obesity, pregnancy, smoking, asthma, delayed stomach emptying
H2 Antagonists
Ranitidine, Famotidine, Cimetidine, Nizatidine
Acid from the stomach enters the esophagus due to a malfunctioning LES.
Inhibit histamine release in histamine-2 receptors on the parietal cells of the stomach, which, in turn, decreases gastric acid secretion.
Not very many common SEs - primarily GI and CNS (drowsiness, dizziness, headaches)
Antacids
Magnesium, Aluminum, Calcium, or Sodium based
Dysphagia
Difficulty swallowing most commonly occurs due to strictures.
Heartburn
Burning sensation in esophagus occurs most commonly postprandial. Due to acid climbing up esophagus and irritating surfaces.
Regurgitation
Flow of refluxed materials into pharynx. Materials generally include mostly acid from stomach with some food particles last ingested.
Cations and anions of compounds react with HCl in stomach to create products like water. These products then increase gastric pH.
Common SEs are GI based: constipation, diarrhea, flatulence
Lifestyle
Head of bed elevation
Food avoidance
Posture post meals
Salivation
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