Medical Management of Gastroesophageal Reflux Disease and the Challenges: A Review

Abstract

Gastroesophageal reflux disease (GERD) is a disorder in the digestive system of the body. GERD in the acute stage is controlled by changing lifestyle. Medicines like antacids, mucosal protective, and prokinetic agents reduce acute GERD by reducing acidity and increasing the motility of the stomach. Proton pump inhibitors(PPIs) are the primary choice of medication for treating GERD, but it is an ineffective number of gastric hypersecretory and other disorders. Ilaprazole, and tenatoprazole are currently under trial in humans and reported to have a longer duration of action. Histamine2 receptors remove some of the PPIs side effects. Tegoprazan is a potent γ-amino butyric acid agonist to treat GERD but has central nervous system side effects, which could be removed as adjunct drugs. Raseglurant and mavogluran have a potential effect in treating GERD, but a major challenge is reducing hepatotoxicity. Dronabinol is the only approved medication for cannabinoid receptors with better efficacy in treating GERD. Challenges that arise during GERD are minimized by using a better combination of drugs. Mylanta, omeprazole, and sustained released baclofen, domperidone, omeprazole, esomeprazole, and rebamipide are more effective and have been used recently in combination for treating GERD patients. Combinations therapy is more effective than monotherapy and also decreases therapeutic challenges which arise by using monotherapy of these drugs in GERD patients.