The gastroesophageal reflux disease is treated gradually, and the doctor, in this case, selects the required course of treatment for the patient. Moreover, today there is a new generation of drugs that can effectively control gastroesophageal reflux. As non-pharmacological methods of treatment, a change in diet and lifestyle can be helpful. It is essential to avoid taking foods and drinks that stimulate the relaxation of the lower esophageal sphincter.
Avoiding foods that provoke GERD symptoms in the diet has a significant role. The education that Ms. Jones should follow should concern the impact of a healthy lifestyle and proper medical care on the duration of the disease and how improper treatment or ignoring it can affect the state of the body. Therefore, it is necessary to study the literature and information about bodyweight control and know about the side effects and contraindications of the drugs taken.
The most effective way to treat GERD is to reduce acid production in the stomach with the help of H2-blockers or proton pump inhibitors. Furthermore, Sandhu and Fass (2018) note that proton pump inhibitors (PPIs) are the basis of medical therapy for GERD. Famotidine is used at a dose of 20 mg twice a day. At night symptoms of 20-40 mg per night are taken, and maintenance therapy of 20 mg per night. This drug does not have a history of asthma or osteoporosis in contraindications so the patient can take them.
Famotidine blocks histamine H2-receptors, inhibits basal and stimulated secretion of hydrochloric acid, and suppresses pepsin’s activity. It is not entirely absorbed from the gastrointestinal tract, and bioavailability is 40 percent, increases under the influence of food, and decreases with antacids. After oral administration, the effect begins after 1 hour, reaches a maximum within 3 hours, and lasts 10-12 hours. The restriction to use is cirrhosis of the liver with hepatic encephalopathy. Side effects of Famotidine are dryness of the oral mucosa, decreased appetite, nausea, vomiting, abdominal pain, decreased blood pressure, headache, asthenia, drowsiness, and allergic reactions.
Based on the chronic nature of gastroesophageal reflux disease, there is a need for supportive therapy and monitoring of the disease. Clinical MII-pH monitoring can help to discriminate rumination from GERD (Nakagawa et al., 2019). Reducing the dose of the drug or attempting to conduct maintenance therapy with a less potent drug than the one used for treatment often leads to a high frequency of relapses.
References
Nakagawa, K., Sawada, A., Hoshikawa, Y., Nikaki, K., Sonmez, S., Woodland, P., Etsuro, Y., & Sifrim, D. (2019). Persistent postprandial regurgitation vs rumination in patients with refractory gastroesophageal reflux disease symptoms: Identification of a distinct rumination pattern using ambulatory impedance-pH monitoring. Official Journal of the American College of Gastroenterology| ACG, 114(8), 1248-1255. Web.
Sandhu, D. S., & Fass, R. (2018). Current trends in the management of gastroesophageal reflux disease. Gut and Liver, 12(1), 7-16. Web.