Proton Pump Inhibitors in the Management of GERD

Abstract

Awareness of new concerns regarding potential side effects of PPIs when used long-term require careful thought as GERD is a chronic disease with most needing some form of medical treatment over time. This article reviews the pharmacologic properties of PPIs and the impact on the treatment of GERD.

Esophageal Sphincter Device for Gastroesophageal Reflux Disease

“…[4][5][6]18,19 The results of the current study show that after magnetic sphincter augmentation, quality-of-life scores significantly improved, as compared with preoperative scores without or with proton-pump inhibitors. At 3 years, 87% of patients (72 of 83 patients) had completely eliminated the use of proton-pump inhibitors.…”

“…Although effective, proton-pump inhibitors provide incomplete control of reflux symptoms in up to 40% of patients. [4][5][6] A partial response can occur because these drugs do not address an incompetent sphincter or prevent reflux; consequently, some patients have only partial relief from symptoms and seek alternative treatment if their quality of life is compromised. At present, the only established option for these patients is antireflux surgery, typically Nissen fundoplication.…”

Magnetic sphincter augmentation and fundoplication for GERD in clinical practice: one-year results of a multicenter, prospective observational study

“…LF has been shown to be an effective and durable therapy for GERD and an alternative to PPI use [8,9]. It is an underutilized treatment considering the high prevalence of GERD and that 30-40 % of patients have reflux symptoms while taking PPIs [10,11]. The LF procedure is technically complex, and outcomes are highly dependent upon a surgeon's experience and judgment.…”

Is Toupet fundoplication the procedure of choice for treating gastroesophageal reflux disease? Results of a prospective randomized experimental trial comparing three major antireflux operations in a porcine model

“…Although medical treatment has shown very good effects [13], it is symptomatic rather than curative for most patients. Surgery offers a cure by physically preventing reflux into the esophagus.…”