Tratamiento con neuromoduladores en la enfermedad por reflujo gastroesofagico

Abstract

Introduction: Gastroesophageal Reflux Disease (GERD) considerably impacts the quality of life, representing a challenge in its clinical management, especially in those patients with a partial response to proton pump inhibitors. Recently, neuromodulators have been positioned as a promising therapeutic option in this context, influencing gastrointestinal motility and pain perception through modification of signal transmission in the nervous system. Methodology: This study reviewed the neuromodulators used to treat Gastroesophageal Reflux Disease. Relevant primary articles were selected, all published in high-impact journals in English or Spanish in the last ten years. The advanced search was performed in PubMed, Scopus, and Web of Science databases. A total of 298 were initially identified, of which six met the eligibility criteria and were analyzed. Results: The studies reviewed presented mixed results. While 5-HT4 receptor agonists showed no significant improvement in GERD symptoms compared to placebo, antidepressants such as citalopram and amitriptyline offered relief in a significant proportion of GERD patients. No conclusive benefit of the combination of mosapride with proton pump inhibitors or acotiamide over standard therapy was found. Conclusions: Neuromodulators exhibit a varied efficacy profile in the treatment of GERD. Despite its potential, especially in managing visceral sensitivity disorders, current evidence is insufficient to recommend its widespread use in clinical practice without rigorous patient selection. Further research is required to determine which patient subgroups may benefit significantly from this therapeutic modality.