MANILA, Philippines - A new, powerful treatment is available to neutralize the bothersome and painful heartburn of gastroesophageal reflux disease (GERD).
“Inadequate symptom control is common with currently available proton pump inhibitors (PPIs), the first-line treatment for GERD. Current PPIs do not provide 24-hour acid control resulting in nighttime symptoms that impair quality of life and work productivity,†said Dr. Melchor Chan, associate professor III at the Department of Medicine, University of Santo Tomas (UST) Faculty of Medicine and Surgery, and chief of the Endoscopy Unit, UST Hospital.
After every meal, millions of tiny pumps (proton pumps) in the stomach produce the acid that helps digest food. At the bottom of the esophagus (the tube that carries food from the mouth to the stomach) is a ring of muscle called the lower esophageal sphincter (LES). The LES opens between the esophagus and stomach to allow food and liquids to enter the stomach.
If the valve does not close all the way, or if it opens too often, stomach acid can move up into the esophagus and cause symptoms like persistent heartburn, stomach acid reflux, burning sensation in the throat, and pain or burning sensation in the chest, among others. This condition is called gastroesophageal reflux (GER).
“Occasional GER is common and does not necessarily mean a person has GERD. However, persistent GER that occurs more than twice a week is considered GERD,†said Dr. Joseph Bocobo, president of the Philippine Society of Gastroenterology.
According to Chan, “Early diagnosis and optimal treatment are important. Untreated, GERD can lead to more serious health problems such as erosive esophagitis and Barrett’s esophagus.â€
Erosive esophagitis develops when the esophagus is irritated and damaged by continued exposure to stomach acid. Barrett’s esophagus is a serious complication of chronic GERD involving changes in the normal tissue lining the esophagus, which can increase the risk for cancer of the esophagus.
GERD treatment involves lifestyle changes and medications; when neither of these treatment options works, surgery is the last recourse.
Lifestyle changes include quitting smoking, avoiding food and beverages that worsen symptoms, losing weight if needed, eating small frequent meals, wearing loose-fitting clothes, avoiding lying down for three hours after a meal, and raising the head of the bed six to eight inches by securing wood blocks under the bedposts.
Common food and beverages that can worsen symptoms include citrus fruits, chocolate, drinks with caffeine or alcohol, fatty and fried food, garlic and onions, mint flavorings, spicy food and tomato-based food like spaghetti sauce, salsa, chili and pizza.
Unlike antacids (e.g. calcium carbonate, magnesium carbonate) and H2 blockers (e.g. cimetidine, famotidine, ranitidine) that provide short-term symptomatic relief, PPIs relieve GERD symptoms and heal the esophageal lining in patients with erosive esophagitis. As such, PPIs are the preferred option for long-term GERD treatment.
Developed by Japan’s largest pharmaceutical company and global industry leader Takeda, dexlansoprazole is the first and only PPI with a Dual Delayed Release (DDR) formulation, enabling the once-a-day capsule to provide 24-hour acid control. Extended duration of action is key to providing round-the-clock heartburn relief, improved sleep and high healing rates of erosive gastritis. Long-term maintenance of erosive esophagitis healing improves patients’ quality of life.
Unlike other PPIs that must be taken 60 minutes before a meal for optimal efficacy, dexlansoprazole can be taken anytime with or without food. “A lifestyle-friendly PPI with flexible dosing can increase patient compliance and enhance treatment success,†said Dr. Sandra Torres, medical director of Takeda Pharmaceuticals Philippines.
Based on evidence suggesting that PPIs may reduce the efficacy of clopidogrel (an anti-platelet drug taken by patients at risk for heart attack or stroke), the US Food and Drug Administration (FDA) discourages the use of omeprazole or esomeprazole with clopidogrel.
“Dexlansoprazole does not diminish the anti-platelet effect of clopidogrel, making it a more favorable choice in patients requiring anti-thrombotic therapy and PPI treatment,†Torres said.