Subject : Participation in survey “To understand the usage pattern of Sodium Alginate Raft forming suspensions in clinical practice”
Acid peptic diseases (APD) encompass conditions whose pathogenesis involves the effect of gastric acid and peptic activity on the tissue. It results from distinctive yet overlapping pathogenic mechanisms that increase acid secretion or diminish the mucosal defence. APD is used as a collective term to include conditions such as GERD, peptic ulcer disease (PUD), gastritis, gastro-duodenal injuries and the resultant bleeding caused by medications (nonsteroidal anti-inflammatory drugs), Zollinger-Ellison, syndrome, and Meckel's diverticulum ulcer. The prevalence of APD in India, as assessed by a hospital- based cross-sectional study, was found to be 38.1%.
GERD is commonest type of acid peptic disease. GERD is defined as symptoms or complications resulting from reflux of gastric contents into the oesophagus or beyond. It accounts for 17.5% of all digestive diseases recorded. GERD has a significant impact on both direct and indirect healthcare costs. The global prevalence of GERD is in the range of 2.5 %-33.1%. Prevalence in India is approximately 18.7%. GERD is associated with significant impairment of quality of life (QoL). Oesophageal exposure to gastric refluxate is responsible for the development of GERD and this can be due to multiple factors. The changes in reflux exposure, epithelial resistance, and visceral sensitivity play an important role in the pathogenesis of GERD. Treatment options for GERD include Antacids, Alginate-based formulations, H2 receptor antagonists, Proton-pump inhibitors and other agents.
Pregnant women may experience heartburn daily and with greater frequency as pregnancy progresses. It may be the first time a woman experiences GERD or it may exacerbate pre-existing reflux disease. Heartburn occurs in approximately 30% to 50% of pregnancies, reaching 80% in some populations. Approximately 17% of pregnant women experience heartburn and regurgitation simultaneously. The incidence of reflux symptoms across the 3 trimesters has recently been reported to be about 25%, with a steady increase in the severity of heartburn over the course of the pregnancy.
Antacids help to provide quick and effective heartburn relief in pregnancy and are safe during lactation. Antacids are recommended as first-line treatment for heartburn in pregnancy when lifestyle modifications fail. About 30%-50% of pregnant patients with symptoms will never need to “step-up” therapy from this drug category. Alginates are considered safe and efficacious to use in the high-risk pregnancy population. In a drug- monitoring retrospective study (1990), 98.1% of pregnant women (n = 52) considered the treatment with Alginate antacid effective and well-tolerated. Another study showed effective control of symptoms within 10-15 days of starting treatment in 18 pregnant patients taking Alginate antacid. A French open-labelled retrospective trial of 50 pregnant women in their second and third trimesters showed 98% symptom improval in frequency, intensity and duration of reflux symptoms. None of these studies demonstrated adverse events to mother or child.
Antacids and alginates help to provide quick, safe and effective heartburn relief in pregnancy and lactation. However, there is limited data available on the preference and rationale on use of antacids, H2RAs & PPI, for APDs in adults and during pregnancy & lactation. Therefore, this multicentric survey is designed to understand the use of these drugs in treatment of heartburn in adults and during pregnancy & lactation.
If you agree to participate, you will be required to respond to questions of the enclosed questionnaire. We trust you and we are partners in promoting safe and effective drug therapy. In that spirit we hope you will consent to participate in this survey. If you do, please sign and return the enclosed reply along with your visiting card for accuracy of records.
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