Editorials
Copyright ©The Author(s) 1998.
World J Gastroenterol. Aug 15, 1998; 4(4): 280-284
Published online Aug 15, 1998. doi: 10.3748/wjg.v4.i4.280
Table 1 Prevalence of reflux in various geographic sites(%)
Weekly symptomsMonthly symptomsEndoscopic damage
U.S.A.[1,2,10]19.8367
Europe[8,37,39,40]12-2321-342
East Asia[4,7,8,9]141.5-5
Table 2 Pathophysiologic factors contributing to the development of reflux
Incompetent lower esophageal sphincter
Low pressure sphincter
Short sphincter length
Poor esophageal peristalsis
Decreased amplitude of contractions
Absence of propagated peristalsis
Delayed gastric emptying
Inadequate gastric contractions
Partial gastric outlet obstruction
Mucosal susceptablity to refluxate
Acid
Pepsin
Bile
Duodenal fluid
Table 3 Pharmacologic agents used in the treatment of reflux
Dosage1Possible mechanism
H2 receptor antagonist
Cimetidine800 mg bid or 400 mg qidReduce acid
Famotidine20 mg bid or 40 mg bidReduce acid
Nizatidine150 mg bidReduce acid, prokinetic
Ranitidine150 mg qidReduce acid
Proton pump inhibitor
Lansoprazole30 mg qdReduce acid
Omeprazole20 mg qdReduce acid
Prokinetic
Cisapride10 mg qid or 20 mg qidProkinetic
Metoclopramide15 mg qidProkinetic