Teodora Surdea-Blaga1, Ion Băncilă2, Daniela Dobru3, Vasile Drug4, Ovidiu Frățilă5, Adrian Goldiș6, Simona M Grad1, Crina Mureșan1, Laurențiu Nedelcu7, Paul J Porr8, Ioan Sporea6, Dan L Dumitrascu9. 1. 2nd Medical Department, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania. 2. Fundeni Clinical Institute, Bucharest, Romania. 3. Gastroenterology Department, University of Medicine and Pharmacy, Târgu Mureș, Romania. 4. Institute of Gastroenterology and Hepatology, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania. 5. Department of Internal Medicine, Emergency Clinical County Hospital, University of Oradea, Oradea, Romania. 6. Gastroenterology and Hepatology Department, Victor Babeș University of Medicine and Pharmacy, Timișoara, Romania. 7. Faculty of Medicine, Transylvania University, Brașov, Romania. 8. Medical Department, County Emergency Hospital, Sibiu, Romania. 9. 2nd Medical Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Abstract
BACKGROUND AND AIMS: Gastroesophageal reflux disease (GERD) therapy is challenging and suppression of acid secretion or prokinetics do not cure all cases. Some drugs with protective action on the esophageal mucosa have been used alternatively or in association with proton pump inhibitors (PPIs) and/or prokinetics. The Romanian Society of Neurogastroenterology undertook an Evidence-Based analysis, from which this position paper evolved. METHODS: We performed a systematic literature search in PubMed until October 2015, using the terms: sucralfate, guaiazulene, gaiazulene, dimethicone, alginate, antacids and gastroesophageal reflux. Forty-seven papers were included and analyzed. Several statements were elaborated regarding the use of these drugs in GERD. The evidence and recommendations were discussed between the authors. RESULTS: There is evidence in the medical literature suggesting the benefit of these drugs in GERD. In patients with persistent or mild reflux symptoms antacids rapidly relieve heartburn. Alginate-antacid combination is superior both over placebo and antacids to treat mild reflux symptoms, and can be used to treat persistent reflux symptoms despite acid suppressant therapy. Sucralfate is superior over placebo in alleviating GERD symptoms and can be used as maintenance therapy. Guaiazulene-dimethicone improves the quality of life in patients with GERD. CONCLUSIONS: Drugs used to protect the esophageal mucosa against acid are useful in alleviating chronic heartburn, especially in patients with mild reflux symptoms.
BACKGROUND AND AIMS: Gastroesophageal reflux disease (GERD) therapy is challenging and suppression of acid secretion or prokinetics do not cure all cases. Some drugs with protective action on the esophageal mucosa have been used alternatively or in association with proton pump inhibitors (PPIs) and/or prokinetics. The Romanian Society of Neurogastroenterology undertook an Evidence-Based analysis, from which this position paper evolved. METHODS: We performed a systematic literature search in PubMed until October 2015, using the terms: sucralfate, guaiazulene, gaiazulene, dimethicone, alginate, antacids and gastroesophageal reflux. Forty-seven papers were included and analyzed. Several statements were elaborated regarding the use of these drugs in GERD. The evidence and recommendations were discussed between the authors. RESULTS: There is evidence in the medical literature suggesting the benefit of these drugs in GERD. In patients with persistent or mild reflux symptoms antacids rapidly relieve heartburn. Alginate-antacid combination is superior both over placebo and antacids to treat mild reflux symptoms, and can be used to treat persistent reflux symptoms despite acid suppressant therapy. Sucralfate is superior over placebo in alleviating GERD symptoms and can be used as maintenance therapy. Guaiazulene-dimethicone improves the quality of life in patients with GERD. CONCLUSIONS: Drugs used to protect the esophageal mucosa against acid are useful in alleviating chronic heartburn, especially in patients with mild reflux symptoms.
Authors: Serhat Bor; İsmail Hakkı Kalkan; Altay Çelebi; Dinç Dinçer; Filiz Akyüz; Peter Dettmar; Hasan Özen Journal: Turk J Gastroenterol Date: 2019-09 Impact factor: 1.852
Authors: Bethany J Slater; Rebecca C Dirks; Sophia K McKinley; Mohammed T Ansari; Geoffrey P Kohn; Nirav Thosani; Bashar Qumseya; Sarah Billmeier; Shaun Daly; Catherine Crawford; Anne P Ehlers; Celeste Hollands; Francesco Palazzo; Noe Rodriguez; Arianne Train; Eelco Wassenaar; Danielle Walsh; Aurora D Pryor; Dimitrios Stefanidis Journal: Surg Endosc Date: 2021-07-19 Impact factor: 4.584