Die Therapie mit Medikamenten stellt die erste therapeutische Maßnahme in der Behandlung einer Refluxerkrankung dar.
Die Einnahme von „Protonenpumpenblocker“ (PPI) haben das Ziel, die akuten Symptome zu beseitigen.
Die PPI- Therapie hat eine Ansprechrate von 85% nach 4 Wochen und 95% nach 12 Wochen.
Die Therapie mit Säureblockern gilt als „Goldstandard“ in der Behandlung des Sodbrennens.
Die Refluxkrankheit wird durch die medikamentöse Therapie in ihrem Verlauf nicht wesentlich beeinflußt (keine wesentliche relevante Progression oder Regression)- sie ist eine rein symptomatische Therapie.
Die Beschwerden sind nach Absetzen der Medikamente rasch wieder da.
Das Wiederkommen einer Erkrankung (Rezidivrate) beträgt 15% innerhalb von Tagen und 80% nach 6 Monaten.
Patienten müssen sich, nach einem Auslassversuch mit erneut auftretenden Beschwerden, für eine Langzeittherapie entscheiden.
In der Langzeittherapie kommt es oft zur Dosissteigerung. Im 1. Jahr müssen 4% mehr als 20mg /tgl. und nach 9 Jahren 45% der Patienten mindestens 40mg/tgl. Säureblocker einnehmen. Zunehmend geraten die PPI, aufgrund neuerer Beschreibungen vieler verschiedener Nebenwirkungen, in die Kritik.
Die beschriebenen Nebenwirkungen sollen neue Argumente für eine kritische Verschreibungspraxis in der Langzeitbehandlung der Refluxösophagitis darstellen.
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