The Esophageal and Swallowing Center, Division of Gastroenterology and Hepatology, MetroHealth Medical Center, Case Western Reserve University, 2500 MetroHealth Drive, Cleveland, OH, 44109, USA.
Curr Gastroenterol Rep. 2020 Mar 17;22(4):16. doi: 10.1007/s11894-020-0753-y.
Despite the many areas of unmet needs in gastroesophageal reflux disease (GERD), proton pump inhibitors (PPIs) remain the cornerstone of medical therapy. However, since their introduction, the therapeutic limitations of PPIs in GERD management have been increasingly recognized.
In this review we discuss the new medical, endoscopic, and surgical therapeutic modalities that have been developed over the last decade. They include the potassium-competitive acid blockers (P-CABs) which provide a rapid onset, prolonged, and profound acid suppression, mucosal protectants which promote the physiological protective barrier of the esophageal mucosa, new prokinetics and neuromodulators. There are growing numbers of novel therapeutic endoscopic techniques that are under investigation or were recently introduced into the market, further expanding our therapeutic armamentarium for GERD. The development of diverse therapeutic modalities for GERD, despite the availability of PPIs, suggests that there are many areas of unmet need in GERD that will continue and drive future exploration for novel therapies.
尽管胃食管反流病（GERD）存在许多未满足的需求领域，但质子泵抑制剂（PPIs）仍然是医学治疗的基石。然而，自它们问世以来，人们越来越认识到 PPIs 在 GERD 管理中的治疗局限性。
在这篇综述中，我们讨论了过去十年中开发的新的医学、内镜和手术治疗方法。它们包括钾竞争性酸阻滞剂（P-CABs），它们提供快速起效、持久和深度的酸抑制作用，黏膜保护剂促进食管黏膜的生理保护屏障，新的促动力药和神经调节剂。越来越多的新型治疗性内镜技术正在研究中或最近被引入市场，进一步扩大了我们治疗 GERD 的手段。尽管有 PPIs 可用，但 GERD 仍有许多未满足的需求领域，这将继续推动未来对新型疗法的探索。
