Narrative treatment of GERD: focus on the lower esophageal sphincter (LES) using raft forming in-situ gelling system

By Shalinee Jain, Dharmendra Jain Gastroesophagus reflux disease, acidity and hearts burning are the most common problems, which can be overcome by the raft forming in-situ gel system containing combination of H2 antagonist and GABAB antagonist as well as raft forming agents (alginate, pectin etc.). GERD develops when the reflux of the gastric contents occur into the esophagus which cause various complication into GIT. The main cause of GERD is an abnormal lower esophageal sphincter (LES) pressure and increased reflux during transient LES relaxation. This review mainly focus on the formulation development for reducing the transient lower esophageal sphincter relaxation (TLESR) rate, attenuating esophageal sensitivity and developing esophageal mucosal protectants. For this purpose GABAB is used which reduces TLESR rate by 40-50% and reflux episodes by 70%, also increase LES pressure and H2 antagonist is used as antisecretory agent in terms of symptomatic relief and mucosal healing. The combined effect of raft forming gelling system is more effective. The review also focuses on the physiological factors, physicochemical factors and formulation factors to be considered in the development of the raft forming system.



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