Drug Treatment in Reflux Disease

As everyone knows, antacid medications can reduce acid production in the stomach and make reflux less painful. Unfortunately, antacids provide short-term pain relief (approximately 1 hour). They then require larger doses. However, higher doses may cause side effects such as diarrhea or constipation. They are insufficient to prevent acid reflux, which increases especially at bedtime, and different medications are required.

Many drugs have been used for this purpose. In addition to drugs called H2 receptor antagonists such as Cimetidine, Ranitidine, Famodin, drugs called proton pump inhibitors such as Omeprazole, Lansoprazole, and Nexium are used today. It is observed that most of the problems disappear, especially when PPI (proton pump inhibitors) are used.

Complaints about reflux are now over. What you need to know is that the disappearance of complaints does not mean that the damage to the esophagus has disappeared. Complaints may start again when medication use is discontinued or interrupted. It should not be forgotten that reflux is a long-term disease.

In Which Situations Is Temporary Drug Treatment Applied?

• If the age is under 60
• If the disease recurs less than 3 times a year
• If the severity of the complaints is mild or can be controlled
• If there is no damage to the esophagus, the patient is treated with intermittent medication.

In Which Situations Is Permanent Drug Treatment Applied?

• If the age is over 60
• If the disease recurs more than 3 times a year
• If there are complaints that disrupt daily life and cannot be controlled with intermittent treatment
• If there is severe esophageal damage
• If other diseases are present, permanent drug treatment is applied to the patient.

Endoscopic Treatments in Reflux Disease

Today, it takes its place in endoscopic treatments in the treatment of reflux disease. There are more rarely applied methods such as endoscopic full-thickness plication (Plicator), suture (Endocinch), Enteryx, Endonetics, Plexiglas microspheres, as well as prominent applications such as Stretta. In the Stretta method, radiofrequency energy is applied to 12-16 points in the lower part of the esophagus, creating 85°C heat for 2 minutes while the mucosa is cooled.

However, these methods, which have an effectiveness of 60-70%, can be applied in cases where there is no hiatal hernia or it is smaller than 2-3 cm, there is no difficulty in swallowing, stenosis and Barrett's esophagus.