Question

Gastroesophageal Reflux Disease discuss any possible secondary complications and suggestions treatments. What are the success rates of these treatments.

Answer 1

Gastroesophageal reflux disease affects millions of people worldwide with significant clinical implications.

Complications-

Esophagitis, Barrett's Esophagus, and Cancer of the Esophagus. Esophagitis, or inflammation of the esophagus, is a complication of GERD. If GERD is left untreated, esophagitis can cause bleeding, ulcers, and chronic scarring. This scarring can narrow the esophagus, eventually interfering with your ability to swallow.

Left untreated, GERD can result in several serious complications, including esophagitis and Barrett’s esophagus. Esophagitis can vary widely in severity with severe cases resulting in extensive erosions, ulcerations and narrowing of the esophagus.esophagitis may also lead to gastrointestinal (GI) bleeding. Upper GI bleeding may present as anemia, hematemesis, coffee-ground emesis, melena, and when especially brisk, hematochezia. Chronic esophageal inflammation from ongoing acid exposure may also lead to scarring and the development of peptic strictures, usually presenting with the chief complaint of dysphagia.

Patients with persistent acid reflux may be at risk for Barrett’s esophagus, defined as intestinal metaplasia of the esophagus. In Barrett’s esophagus, the normal squamous cell epithelium of the esophagus is replaced by columnar epithelium with goblet cells, as a response to acid exposure. Changes of Barrett’s esophagus may extend proximally from the gastroesophageal junction (GEJ) and have the potential to progress to esophageal adenocarcinoma, making early detection very important in the prevention and management of malignant transformation.

GERD Treatment: Medication

• Antacids. Over-the-counter antacids are best for intermittent and relatively infrequent symptoms of reflux. ...
• Histamine blockers. Histamine 2 (H2) blockers are drugs that help lower acid secretion. ...
• Proton pump inhibitors. ...
• Prokinetic agents.

In addition, oral pantoprazole has been shown to improve the quality of life of patients with GERD and is associated with high levels of patient satisfaction with therapy. GERD appears to be more common and more severe in the elderly, and pantoprazole has shown to be an effective treatment for this at-risk population.

Fundoplication is associated with a high level of patient satisfaction and improved quality of life in patients with chronic GERD. According to the guidelines written by the American Society for Gastrointestinal and Endoscopic Surgeons (SAGES), surgical procedures for GERD are curative in 85%-93% of cases.