Reflux esophagitis very afflictive, what drug should take?

2022-08-19 0 By

Gastroesophageal reflux disease refers to a disease in which gastroduodenal contents reflux into the esophagus, mouth (throat) and lung, causing a series of uncomfortable symptoms and/or complications. The symptoms of this disease include esophageal symptoms and extra-esophageal syndrome, and the main diagnostic basis includes reflux esophagitis with esophageal symptoms.And reflux laryngitis syndrome, reflux asthma syndrome, reflux cough syndrome, reflux dental erosion disease and so on.Reflux esophagitis is caused by the malfunctioning of the lower esophageal sphincter and the reflux of stomach and/or duodenal contents into the esophagus, resulting in inflammation, erosion, ulcers and fibrosis of the esophageal mucosa.This disease is a dynamic disorder of upper digestive tract caused by many factors.Figure source network: The main pathological basis of invasive reflux esophagitis is prolonged exposure time of esophageal acid, decreased pressure of lower esophageal sphincter and esophageal peristalsis dysfunction, leading to the failure of timely and effective removal of gastric acid, resulting in reflux esophagitis.The clinical manifestations of the disease are mainly chest pain, dysphagia, acid reflux, heartburn, severe ulcer, bleeding and so on.Proton pump inhibitors (PPI) are currently the most effective drugs in the treatment of GASTROesophageal reflux disease, such as omeprazole, pantoprazole, esomeprazole.All three drugs are commonly used proton pump inhibitors, which help suppress gastric acid secretion and are effective in treating GASTROesophageal reflux disease.Omeprazole can reduce the activity of H+-K+ -ATPASE in gastric mucosal parietic cells and inhibit the gastric acid secretion caused by basal gastric acid and stimulating factors, thus inhibiting the damage of gastric acid to esophageal mucosa and achieving the purpose of treating gastroesophageal reflux disease.However, acid suppressors alone in the treatment of GASTROesophageal reflux disease cannot enhance gastric motility or fundamentally prevent reflux. Therefore, gastric motility stimulants are generally combined to enhance the pressure of the lower esophageal sphincter, promote the amplitude and intensity of esophageal contraction, and promote gastric empties.Pantoprazole is a novel proton pump inhibitor, which can specifically act on secretory tubules of gastric wall cells, irreversely bind to proton pump-ATPASE in microtubules, significantly inhibit gastric acid secretion, reduce gastric acid damage to esophageal mucosa, and quickly relieve symptoms.Compared with promeprazole, the representative drug of proton pump inhibitors, promeprazole is more stable than promeprazole under neutral and slightly acidic conditions, and its bioavailability is also higher, and its acid inhibition ability is not inferior to promeprazole.And diazepam tora azole sodium for the third generation of proton pump inhibitors omeprazole is left-handed optical isomer, the drug of the liver to eliminate endogenous rate is lower than R isomer, blood drug concentration high and persistent, formed in the cell in the lining of the microtubule system times sulfonamide class products, help to enhance the effect of proton pump potent inhibition of gastric acid secretion.In addition, one of the most prominent advantages of pantoprazole sodium is that it does not induce or inhibit the activity of hepatocellular cytochrome P450 enzyme. Therefore, when used in combination with drugs metabolized by P450 enzyme system, it is not easy to have competitive effects of drug metabolic enzyme system and reduce drug interactions.This also provides more drug options for gerD patients with other systemic diseases.Similarly, a combination of pantoprazole sodium and mosapride may be more effective in the treatment of reflux esophagitis, resulting in a higher remission rate of reflux esophagitis symptoms.Moxapride is a novel gastric motility stimulant, which can enhance peristalsis and lower esophageal sphincter tension, prevent reflux of gastric contents into the esophagus, and increase anti-reflux effect.Therefore, in the treatment of gastroesophageal reflux disease such as reflux esophagitis, acid inhibitors and gastrointestinal motility agents are generally used together.Reflux esophagitis is a relatively common clinical digestive system disease, especially in the elderly, for this kind of population, in addition to drug treatment, more attention should be paid to the overall care.Routine care includes making patients aware of the etiology, pathogenesis, symptoms, treatment methods and daily attention of reflux esophagitis, so as not to affect the treatment.Secondly, as reflux esophagitis will bring a lot of discomfort and inconvenience to patients, attention should also be paid to maintaining the mental health of patients and improving their compliance to treatment.In addition, patients in the diet to choose the best high nutrition, high protein, easy to digest liquid food, avoid eating spicy stimulation and hard food.Still have, the patient of reflux sex esophagitis because stomach content is easy to reflux to oral cavity, cause influence to oral health, therefore also want to pay attention to oral health, after the meal brush teeth gargle.If you have the habit of smoking, you should quit smoking, so as not to aggravate the injury of esophageal mucosa.It’s more important to take your medicine on time.Conclusion Poor eating habits, living habits or aging may lead to the occurrence of GASTROesophageal reflux disease, and in order to prevent the occurrence of disease, we should cultivate good eating habits in life, eat regularly, avoid overeating.If gerD is diagnosed, it should be treated in a timely manner, so as not to deteriorate and induce other more serious digestive diseases, but also to reduce the inconvenience and impact on life.[1] Chen Yan, SUI Xinke, Huang Xin, et al.Analysis of risk factors for extra-esophageal symptoms in patients with reflux esophagitis [J]. Chinese Medical Journal, 2021(8) : 808-811.[2] Yang Chunrong.[3] Wang Shaping, Liu Xiaosu. Effect of omeprazole combined with mosapride in the treatment of reflux esophagitis [J]. Chinese Women’s Health (2nd half month), 2013(5) : 86.[4] Wang Y, Wang Y, Wang Y, et al. Effect of holistic nursing on the development of esophageal reflux esophagitis in elderly patients [J]. J Gastroenterol, 2018(3) : 450-454.Clinical study of pantoprazole combined with itoppiril in the treatment of reflux esophagitis [J]. Chinese Journal of Doctor Training, 2010(13) : 32-33.[5] Jiang LAN.[6] Hu SL. (in Chinese) Pantoprazole sodium + mosablide in the treatment of gastroesophageal reflux disease [J]. Shandong Medicine, 2014(21) : 66-67.Cost-effectiveness of promeprazole, pantoprazole and esomeprazole as proton pump inhibitors in the treatment of reflux esophagitis [J].World Latest Medical Information Abstracts (Continuous electronic journal), 2019(95) : 185-186.