RESULTS OF SHORT-TERM MEDICAL TREATMENT OF GASTRO-OESOPHAGEAL REFLUX DISEASE: COMPARISON OF TWO THERAPEUTIC APPROACHES

Authors: M. Ivan, C. Stanciu

Abstract:

Background: Gastro-oesophageal reflux disease (GERD) is a common problem which is expensive to diagnose and treat. The medical treatment of gastro-oesophageal reflux disease is accomplished with the appropriate use of anti-secretory therapy, mainly proton pump inhibitors (PPI) and prokinetic agents (PA).
Aim: To compare the efficacy of PPI (omeprazole) and PPI associated with PA (metoclopramide) at their standard dosages in suppressing oesophageal acid exposure in uncomplicated gastro-oesophageal reflux disease.
Method: 164 patients diagnosed with GERD at the Institute of Gastroenterology and Hepatology of Iasi, Romania between 1994 and 2006, were treated using PPI alone or PPI associated with PA for 6 weeks. The results were assessed after 4 and 6 weeks using clinical methods, endoscopy and pH monitoring. Results: PPI associated with PA was 3 times more efficient in treating GERD with an increased rate of complete remission of symptoms. Erosive lesions and heartburn disappeared in 70.9% of the cases treated with PPI and PA compared to 61.3% when using PPI alone. Conclusions: Normalization of oesophageal acid exposure can be achieved in most of the uncomplicated GERD cases with PPI (twice daily) associated with PA (3 times a day) for 6 weeks.