Curbside Consultation in GERD: 49 Clinical Questions

Philip O. Katz, MD

Question 15: What Is The Mechanism Of Action Of Antisecretory Therapy For Gerd? (continued)

Antisecretory agents (H2 receptor antagonists [H2RAs] and proton pump inhibitors [PPIs]) inhibit gastric acid secretion and raise intragastric pH decreasing the damaging potential of the refluxate. The number of hours the pH is >4.0 is considered an efficacy measure of the inhibition of acid secretion. When intragastric pH <4.0, pepsinogen is activated to pepsin, which can exacerbate esophageal mucosal damage caused by the acid. A prospective study has found that healing of erosive esophagitis symptom relief by acid-suppressive agents is related to the duration of gastric acid…