The Role of Proton Pump Inhibitors in Gastro-oesophageal Reflux Disease

Dekel, Roy; Morse, Chad; Fass, Ronnie

doi:10.2165/00003495-200464030-00004

Cited by 51 publications

(32 citation statements)

References 108 publications

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“…healing and effective (as well as durable) control of GERD-related symptoms. 3,4 Despite the marked developments in medical, endoscopic, and surgical therapy, there are still many areas of unmet need in the treatment of GERD. Advanced grades of EE (Los Angeles grades C [LA-C] and D [LA-D]) demonstrate the lowest healing rates in patients on PPI once daily.…”

Section: Introductionmentioning

confidence: 99%

Unmet Needs in the Treatment of Gastroesophageal Reflux Disease

Dickman

Maradey–Romero

Gingold‐Belfer

et al. 2015

J Neurogastroenterol Motil

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Gastroesophageal reflux disease (GERD) is a highly prevalent gastrointestinal disorder. Proton pump inhibitors have profoundly revolutionized the treatment of GERD. However, several areas of unmet need persist despite marked improvements in the therapeutic management of GERD. These include the advanced grades of erosive esophagitis, nonerosive reflux disease, maintenance treatment of erosive esophagitis, refractory GERD, postprandial heartburn, atypical and extraesophageal manifestations of GERD, Barrett's esophagus, chronic protein pump inhibitor treatment, and post-bariatric surgery GERD. Consequently, any future development of novel therapeutic modalities for GERD (medical, endoscopic, or surgical), would likely focus on the aforementioned areas of unmet need.

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Section: Introductionmentioning

confidence: 99%

Unmet Needs in the Treatment of Gastroesophageal Reflux Disease

Dickman

Maradey–Romero

Gingold‐Belfer

et al. 2015

J Neurogastroenterol Motil

Self Cite

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“…GERD has been shown to have a significant impact on health-care utilization and patient’s quality of life [3,4]. The introduction of proton pump inhibitors (PPIs) has entirely revolutionized the medical management of GERD [5,6,7]. PPIs are well tolerated and superior to any other established medical treatment strategy including H 2 -receptor antagonists in achieving both symptom control and mucosal healing rates [8].…”

Section: Introductionmentioning

confidence: 99%

Prospective Evaluation of Duodenogastroesophageal Reflux in Gastroesophageal Reflux Disease Patients Refractory to Proton Pump Inhibitor Therapy

Kunsch¹,

Neeße²,

Linhart³

et al. 2012

Digestion

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Background: Duodenogastroesophageal reflux (DGER) is considered an independent risk factor for complicated reflux disease (gastroesophageal reflux disease; GERD). However, the role of DGER in GERD patients refractory to proton pump inhibitors (PPI) remains poorly understood. Methods: 85 patients with clinical reflux symptoms and a history of ineffective response to PPIs were enrolled in the study. Patients with elevated reflux measurement (pH and/or Bilitec measurement; n = 47) received pantoprazole 80 mg for 8 weeks. Clinical outcome was defined as response (≤2 symptoms/week) or nonresponse (≥3 symptoms/week). Results: Of the 47 patients with elevated reflux measurement, 30 were classified as responders and 17 as nonresponders. Treatment with pantoprazole resulted in a significant reduction of acidic reflux in both PPI responders and PPI nonresponders. In contrast, DGER was only significantly reduced in the PPI responder group (22.8 ± 22.8 vs. 6.6 ± 10.8%; p < 0.05) but not in the PPI nonresponder group (24.5 ± 18.6 vs. 22.2 ± 12.7%; p > 0.05). Conclusions: The presented study firstly describes that nonresponsiveness to PPI is associated with a limited effect of PPIs on reducing DGER. Thus, persistent DGER may play a key role in mediating reflux symptoms refractory to high-dose PPIs.

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“…PPIs, by binding the final common pathway of acid secretion -the H + /K + adenosine triphosphatase (the proton pump), have markedly improved the medical therapy of GERD. Thus far, there is a number of clinical data available demonstrating that PPIs are superior to H 2 RAs in both acute management and maintenance therapy of erosive esophagitis [18] . In contrast, there are very limited studies (controlled, clinical trials) assessing antisecretory treatment in peptic stricture healing and, furthermore, how the healing of esophagitis (with acid-suppressive therapy) relates to peptic stricture outcome.…”

Section: Acid-suppressive Therapymentioning

confidence: 99%

Peptic Esophageal Stricture: Medical Treatment

Pregun

Hritz

Tulassay

et al. 2009

Dig Dis

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Peptic esophageal stricture as a consequence of gastroesophageal reflux disease is the most frequent among benign esophageal strictures. The incidence is low and has been decreasing since the 1990s with a parallel increase in proton pump inhibitor use. Dysphagia is a common symptom: accurate diagnostic procedures (barium esophagogram, upper endoscopy with biopsies) have to be performed to exclude malignant causes first. Medical (acid-suppressive) therapy, endoscopic dilation and surgical intervention are the main therapeutic options. Based on the results of randomized and observational studies evaluating the effect of acid-suppressive therapy on peptic stricture outcome, healing the coexistent esophagitis seems to be essential. Effective acid-suppressive therapy with proton pump inhibitors may reduce the need for repeated dilations and provide symptom relief and better clinical outcome. In refractory strictures, local steroid injection is likely beneficial.

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The Role of Proton Pump Inhibitors in Gastro-oesophageal Reflux Disease

Cited by 51 publications

References 108 publications

Unmet Needs in the Treatment of Gastroesophageal Reflux Disease

Unmet Needs in the Treatment of Gastroesophageal Reflux Disease

Prospective Evaluation of Duodenogastroesophageal Reflux in Gastroesophageal Reflux Disease Patients Refractory to Proton Pump Inhibitor Therapy

Peptic Esophageal Stricture: Medical Treatment

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