The pharmacotherapeutic management of gastroesophageal reflux disease (GERD).

Introduction: Gastroesophageal reflux disease (GERD) is a very common worldwide condition, affecting about 15-20% of the whole population, and representing a major burden for health-care systems. Because of its frequency, health physicians - family doctors as well as specialists - should be aware of the different pharmacotherapeutic approaches in managing GERD, according to disease severity.

Areas Covered: Authors summarize the pharmacological management of GERD in adults, present the different pharmaceutical classes, and review the evidence on efficacy for each treatment according to the most common clinical scenarios: non-erosive gastroesophageal reflux disease (NERD), erosive esophagitis (EE), and proton-pump inhibitor (PPI) refractory GERD.

An update on the latest chemical therapies for reflux esophagitis in children.

Introduction: Gastroesophageal reflux (GER), and its complicated form gastroesophageal reflux disease (GERD) is a common condition in infants and children. As GERD is often considered to cause extra-oesophageal symptoms in children and in the absence of standardized diagnostic and treatment algorithm, many children are inappropriately exposed to empirical anti-reflux treatments, with Acid-Suppressive Medications (ASM); mostly proton pump inhibitors (PPIs).

Areas Covered: The authors summarize the pharmacological management of pediatric GERD and discuss the efficacy of PPIs as randomized controlled trials have failed to demonstrate their clinical efficacy in the pediatric population.

Safety of medication options for treating pediatric esophagitis.

Introduction: The management of gastro-esophageal reflux and esophagitis in infants and children is challenging, and there are currently no clear practice guidelines. Given a paucity of evidence in the treatment of pediatric esophagitis, there are concerns over both the efficacy and safety of proton-pump inhibitors, histamine type 2 receptor antagonists, and prokinetics.

Areas Covered: Comprehensive data from randomized-controlled trials, meta-analyses and observational studies have helped to illustrate the efficacy and safety of various pharmacologic and non-pharmacologic treatments in pediatric esophagitis.