About gastroesophageal reflux disease
Gastroesophageal reflux disease (GERD) is a digestive disorder where gastric acid unintentionally flows into the esophagus. In contrast to the stomach, the lining of the esophagus is not resistant to acid. Hence, acid reflux can cause severe pain, difficulty in swallowing and esophageal erosions or ulcerations (esophagitis).
The fact that GERD related pain is often referred for as “heartburn” illustrates its intensity. Patients referred for emergency care under suspicion of a heart attack are sometimes shown to suffer from GERD. Symptoms often occur at night, causing difficulties to sleep which can in turn impact quality-of-life.
"...not even the acid blocking properties of PPIs are sufficient to help all patients – acid breakthroughs occur daily during therapy and the full onset of action takes days."
The medical treatment of GERD and esophagitis basically consists of drugs that reduce the amount of gastric acid. Over the years, more and more efficacious therapies have been introduced. In the late seventies and early eighties, H2 blockers like Tagamet and Zantac became top-selling drugs based on their superiority over antacids. In the late eighties and nineties, proton pump inhibitors (PPIs) like Losec and Nexium swiped the market based on their superiority over H2 blockers. But not even the acid blocking properties of PPIs are sufficient to help all patients – acid breakthroughs occur daily during therapy and the full onset of action takes days.
Wilder Smith C et al, (2001).
"Cinlcus, data on file"
Today's most efficient GERD therapies, leave patients exposed to acid reflux for substantial parts of the day. Approximately 40 percent (Crawley et al, 2000) of patients treated with PPI were not satisfied with their treatment. More than 35 percent of patients with severe esophagitis (grades C or D) are not healed despite standard high dose PPI treatment schedule.