Overview of the disease
Gastroesophageal reflux disease (GERD) is characterized by a burning sensation in the chest and throat. The disease is initiated by alteration of the sphincter valve at the junction between the stomach and the esophagus. The abnormal sphincter allows reflux movement of stomach contents into the esophageal region.
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One of the main stomach contents that move to the lower esophageal mucosa is stomach acid which corrodes the mucosa membrane, causing inflammation and burning pain. In a healthy person, the sphincter valve between the stomach and the esophagus does not permit reflux of substances to the esophageal area. The protective mechanism ensures that the corrosive stomach acid does move to the esophageal region and corrode it.
Importance of the medications to the condition
The histamine 2 blocker (Pepcid) is in the class of drugs that reduce production of the gastric acid by inhibiting the activity of histamine on histamine H2 receptors (Lin, Chang, Hsu, Tseng & Huang, 2010). Histamine binds to the histamine H2 receptors on the parietal cells of the stomach to initiate production of the gastric acid.
The histamine 2 blockers are used in patients with GERD to inhibit secretion of the gastric acid which corrodes the mucous membrane of the esophagus (Lin et al., 2010). The proton pump inhibitor (Prilosec) is in the class of drugs that permanently block gastric proton pump which is essential for the secretion of the gastric acid by the parietal cells of the stomach (Sopo, Radzik & Calvani, 2009).
The pump plays a key role of adding hydrogen ions to the secretion that makes gastric acid (Testoni et al., 2010). Therefore, this class of drugs ensures that the last stage gastric acid secretion is inhibited and that no stomach acid would be secreted by the parietal cells of the stomach. The drug facilitates healing of the GERD better than the histamine 2 blockers, and they have longer pharmacological effects (Lin et al., 2010).
Dietary plays a key role in the management of the GERD (Festi et al., 2009). Patients suffering from GERD who control their dietary intake take a shorter time to heal from the disease than those who do not strictly follow dietary instructions.
Research shows that some foods may facilitate the progression of GERD by promoting the secretion of the corrosive gastric acid and injury to the esophagus. Some of these foods are chocolate, fatty acids and spicy foods. Weight loss is also necessary in the management of the disease because weight gain has been linked with elevated secretion of the gastric acid (Festi et al., 2009).
It has also been demonstrated that eating before lying down helps to minimize the symptoms associated with GERD. The patient should take small food portions to minimize the symptoms of the disease. It is also recommended that people suffering from GERD should eat supper 2 hours before they retire to their beds. Smoking should be avoided because it has been shown to alleviate the symptoms of GERD.
Avoidances and changes to make to avoid progression of the disease
Lifestyle changes and maintenance are essential in the management of GERD (Festi et al., 2009). The patient should not take part in rigorous physical exercises because they have been linked with progression of GERD. The patient should follow the dietary instructions strictly to avoid progression of the disease. The head of the bed on which the patient sleeps should be slightly elevated to help reduce chances of reflux movement of gastric acid into the esophagus during sleep.
Festi, D., Scaioli, E., Baldi, F., Vestito, A., Pasqui, F., Di Biase, A. R., & Colecchia, A. (2009). Body weight, lifestyle, dietary habits and gastroesophageal reflux disease. World journal of gastroenterology: WJG, 15(14), 1690.
Lin, P. C., Chang, C. H., Hsu, P. I., Tseng, P. L., & Huang, Y. B. (2010). The efficacy and safety of proton pump inhibitors vs histamine-2 receptor antagonists for stress ulcer bleeding prophylaxis among critical care patients: a meta-analysis. Critical care medicine, 38(4), 1197-1205.
Sopo, S. M., Radzik, D., & Calvani, M. (2009). Does treatment with proton pump inhibitors for gastroesophageal reflux disease (GERD) improve asthma symptoms in children with asthma and GERD? A systematic review. J Investig Allergol Clin Immunol, 19(1), 1-5.
Testoni, P. A., Corsetti, M., Di Pietro, S., Castellaneta, A. G., Vailati, C., Masci, E., & Passaretti, S. (2010). Effect of transoral incisionless fundoplication on symptoms, PPI use, and ph-impedance refluxes of GERD patients. World journal of surgery, 34(4), 750-757.