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2015, Number 1-2

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Cir Gen 2015; 37 (1-2)

Current treatment of gastroesophageal reflux disease

González-Izquierdo JJ, Hernández-Aguilar TJ, Palomares-Chacón UR, Castelltor HLF, Pérez NJV, Anaya-Prado R

Language: Spanish
References: 47
Page: 38-43
PDF size: 190.25 Kb.


ABSTRACT

Gastroesophageal reflux disease is defined as a failure of the anti-reflux barrier that leads to abnormally high digestive secretions passing into the esophagus, which produces symptoms of esophageal and extra-esophageal damage. The physiological mechanisms that prevent reflux are clearance, the lower esophageal sphincter and the right gastric emptying. Failure in these defense mechanisms leads to gastroesophageal reflux. Surgical treatment of gastroesophageal reflux disease has been in constant evolution over the past 70 years. Nissen fundoplication, Belsey’s and Hill gastropexy have been studied and modified over time, and with different approaches. An effective treatment is to reduce acid secretion of the stomach with either an H2 receptor antagonist or a proton pump inhibitor. The dose depends on the severity of each patient: the greater the esophageal exposure to acid, the greater will be the degree of suppression required to cure it. There is currently much debate about the benefits of the medical or surgical treatments, and the role of laparoscopic surgery as a first-time or second approach. The objective of this paper is to determine the surgical and medical treatment options currently available.


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