Consensus Statement for Management of Gastroesophageal Reflux Disease

Moss, Steven F.; Arnold, R.; Tytgat, G. N. J.; Spechler, Stuart J.; Fave, G. Delle; Rosin, Danny; Jensen, Rigmor; Modlin, Irvin M.

doi:10.1097/00004836-199807000-00004

Cited by 24 publications

(8 citation statements)

References 14 publications

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“…Hiatal hernia was defined as a distance of more than 2 cm between the diaphragm and the gastroesophageal junction. Barrett’s esophagus was defined as the presence of columnar-lined epithelium in the esophagus [20]. All patients in whom endoscopy did not show any abnormality in the esophagus, stomach and duodenum were used as the control group.…”

Section: Methodsmentioning

confidence: 99%

Colonization with cagA-Positive Helicobacter pylori Strains Inversely Associated with Reflux Esophagitis and Barrett’s Esophagus

et al. 2000

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Aim: The hypothesis that colonization with cagA⁺ Helicobacter pylori strains protects against the development of gastroesophageal reflux disease (GERD) and its complications is tested. Methods: Patients with reflux esophagitis and Barrett’s esophagus were studied. Antral biopsy specimens were obtained for detection of H. pylori. A serum sample was obtained for determination of IgG antibodies to H. pylori and to the CagA protein. Results: 736 patients were studied. 118 patients had reflux esophagitis, 36 had Barrett’s esophagus, 108 had hiatal hernia without signs of inflammation (the reflux group), and 20 patients had esophageal or stomach cancer. The remaining 454 patients had no signs of GERD. The 262 patients with reflux disease had a significantly lower prevalence of H. pylori (34.9%) than the 454 controls (54.6%; p < 0.001). Among 310 H. pylori-positive patients from whom serum was available, colonization with cagA⁺ strains was detected in 59% in the control group versus 35% in the reflux group (p < 0.001). Conclusion: Patients with reflux esophagitis and Barrett’s esophagus have a significantly lower prevalence of H. pylori colonization than controls, in particular of the cagA⁺ type. These data suggest that colonization with cagA⁺ H. pylori strains may be protective against the development of GERD

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Section: Methodsmentioning

confidence: 99%

Colonization with cagA-Positive Helicobacter pylori Strains Inversely Associated with Reflux Esophagitis and Barrett’s Esophagus

et al. 2000

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“…A recent consensus statement from Yale University on the treatment of GERD also states that symptom relief may not be adequate with 20 mg of omeprazole, and that ‘the dose of this drug might need to be increased to 20 mg b.i.d. or even more to achieve optimal results’ [76]. On the other hand, increasing the pantoprazole dose to 80 mg provides no additional benefit over the usual 40-mg dose in the majority of patients, even after 8 weeks of therapy [74], and the prescribing information is consistent with these findings [77].…”

Section: Gastroesophageal Reflux Diseasementioning

confidence: 97%

The Clinical Importance of Proton Pump Inhibitor Pharmacokinetics

Yacyshyn

Thomson

2002

Digestion

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Achieving the optimal clinical response for patients with upper gastrointestinal peptic disease is important. This response depends on the pathology treated as well as on the choice of proton pump inhibitor. Here, we identify factors in specific disease therapy and proton pump inhibitor (PPI) pharmacokinetic and pharmacodynamic characteristics that help us achieve this goal. These include differences in PPI bioavailability and acid-suppressive effects. Available data indicate that PPIs appear to have similar potency on a milligram basis, and that omeprazole and lansoprazole are more frequently double dosed than pantoprazole. The lower propensity for double dosing with pantoprazole may also result in lower medication acquisition costs and a reduction in physician visits due to ineffective therapy with the standard dosing of these other agents.

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“…Diagnosis and follow-up of reflux esophagitis are best accomplished by means of upper GI endoscopy, which, in addition to providing macroscopic diagnosis of esophageal lesions, enables the collection of biopsy specimens for histopathological analysis (9) .…”

Section: Introductionmentioning

confidence: 99%

Assessment of effectiveness of different dosage regimens of pantoprazole in controlling symptoms and healing esophageal lesions of patients with mild erosive esophagitis

Moretzsohn

Brito

Reis

et al. 2002

Arq. Gastroenterol.

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-Background -Gastroesophageal reflux disease is a very common affection, and esophageal involvement is particularly frequent. The means to effectively control symptoms and improve esophageal inflammation in these patients is to reduce esophageal acid exposure. For this purpose, we use gastric proton pump inhibitor, that can suppress gastric acid secretion. Aim -To compare the effectiveness of two different pantoprazole dosage regimens (20 and 40 mg/day), in controlling symptoms and healing esophageal lesions of patients with mild erosive esophagitis. Material and Methods -Fiftyseven patients with endoscopically confirmed mild erosive esophagitis characterized as non-confluent erosions in the distal esophagus, were randomly to be treated either with pantoprazole 20 mg/day (group I, 28 patients) or 40 mg/day (group II, 29 patients) over a period of 4 weeks. After treatment completion, the patients were assessed for clinical and endoscopic outcome, i.e., absence of erosions in distal esophagus and improvement of gastroesophageal reflux symptoms. Results -At the end of the treatment, 73.1% of the patients in group I and 85.7% of the patients in group II had endoscopic improvement. We also observed, that 88.5% of the patients in group I and 92.9% of the patients in group II had complete elimination of heartburn and regurgitation. Conclusion -Pantoprazole dosage regimens of 20 mg/day and 40 mg/day provide equivalent effectiveness in controlling symptoms and healing esophageal lesions of mild esophagitis.

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Consensus Statement for Management of Gastroesophageal Reflux Disease

Cited by 24 publications

References 14 publications

Colonization with <i>cag</i>A-Positive <i>Helicobacter pylori</i> Strains Inversely Associated with Reflux Esophagitis and Barrett’s Esophagus

Colonization with <i>cag</i>A-Positive <i>Helicobacter pylori</i> Strains Inversely Associated with Reflux Esophagitis and Barrett’s Esophagus

The Clinical Importance of Proton Pump Inhibitor Pharmacokinetics

Assessment of effectiveness of different dosage regimens of pantoprazole in controlling symptoms and healing esophageal lesions of patients with mild erosive esophagitis

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