Retrograde movement of gastric contents from the stomach into the esophagus. when reflux leads to to inflamation (with or without eration or ulceration) of the esophagus as it is called Reflux esophagitis.
Gastro-oesophageal Reflux disease(GORD)
Abdominal motility problem that reflux of acid and other noxious substances, when noxious substances in the refluxate are in contact with the esophageal mucosa long enough to cause irritation and inflammation.
Treatment of Gastro-oesophageal Reflux disease(GORD)
First choice use antacid preparation (eg. aluminium hydroxide and magnesium hydroxide) if patient is not a chronic renal disease patient.
It should be taken 1-1.5 hours after meal .
Liquid dosage form is more potent than solid doses form.
I suggest that Sodium Bicarbonate preparation should avoid in hypertensive patient. Calcium carbonate and magnesium Hydroxide preparation should also be avoid.
If antacid can’t relieve the symptoms alone should use H2 receptor blocker drugs (eg. famotidine or Nizatidine.) or PPI ( eg. esomeprazole, pantoprazole or lansoprazole).
Dose adjustment
Nizatidine
150 mg two times daily for 4 weeks 30 minutes before the meal, then once daily at night for two weeks, if symptoms not relief extend the the treatment time for two weeks.
Famotidine
20 mg two times daily for 4 weeks 30 minutes before the meal, then once daily at night for two weeks, if symptoms not relief extend the the treatment time for two weeks.
PPI ( Proton Pump Inhibitor)
Esomeprazole 20 mg or prantoprazole 40 mg may be given 2 times a day 30 minutes before of meal for 3 weeks. Last 1 weeks once a day at night before the 30 minutes of meal. Dexlansoprazole is better to use 30 mg 1 or 2 times a day for 4 weeks. First 20 days 2 times a day 30 minutes before the meal and then 10 days a single dose for withdrawing the drug at night before the 30 minutes of meal.
With added a antacid preparation (eg. aluminium hydroxide and magnesium hydroxide) 1-1.5 hours after meal .
Advice
It is very important for all gastritis,Peptic ulcer disease, duodenal ulcer disease , gastroesophageal reflux disease, gastric ulcer disease patients .
Diet
Patient should concern about his meal.
Should be less spicy less oily .
Less consume free sugar or sugar containig in food
Try to avoid heavy fibre food
Avoid coffee
Alcohol
Avoid milk
Cigarette are prohibited strongly.
Lifestyle
Patient should obey the following guideline for better feel and withdrawal the medication .
Daily activities
Wake up at morning 6 a.m take a glass of fresh water
Then take100- 150 gram green papaya
Then take breakfast at 8 a.m.
At 11 a.m. take a sugar free toast biscuit with a glass of fresh water, then chewing a chewing gum for 40 to 50 minutes.
Take your lunch within 2 p.m.
At 5 p.m. take a sugar free toast biscuit with a glass of fresh water.
Then chewing a chewing gum for 40 to 50 minutes.
Take your dinner within 8 to 9 p.m.
Go to bed within 10:00 to 10:30 p.m.
Note: If sprinter become more deform please go to surgery.
