Gastroenterology and Hepatology
- William D. Carey, MD
Since this article does not have an abstract, we have provided the first 150 words of the full text.
Excerpt
Pharmacotherapy for gastroesophageal reflux disease is needed when simple measures fail. Antacids, H2 blockers, sucralfate, and (occasionally) metaclopramide may be effective. Treatment failures may respond to omeprazole (Prilosec), a recently released agent that blocks hydrogen ion secretion by the gastric parietal cells. It is the most potent acid-suppressing agent available and is unsurpassed in its ability to provide symptomatic control and promote esophageal mucosal healing (80% to 86% at 6 weeks, >90% at 12 weeks). Since this agent is approved for use for only 8 weeks of therapy, both physician and patient face a dilemma of what to do next in managing this chronic disease. Omeprazole also represents an advance in healing rates for both gastric and duodenal ulcers. Two weeks of therapy may be adequate. Compared with ranitidine, omeprazole had a 17% higher healing rate after 2 weeks of therapy (79% vs 62%). The healing rate after 4
