PPI-Refractory GERD: an Intriguing, Probably Overestimated, Phenomenon

Author:

Baldi Fabio

Publisher

Springer Science and Business Media LLC

Subject

Gastroenterology,General Medicine

Reference10 articles.

1. Carlsson R, Dent J, Watts R, et al. Gastro-oesophageal reflux disease in primary care: an international study of different treatment strategies with omeprazole. International GORD Study Group. Eur J Gastroenterol Hepatol. 1998;10:119–24.

2. Inadomi JM, McIntyre L, Bernard L, et al. Step-down from multiple- to single-dose proton pump inhibitors (PPIs): a prospective study of patients with heartburn or acid regurgitation completely relieved with PPIs. Am J Gastroenterol. 2003;98:1940–4.

3. Sifrim D, Zerbib F. Diagnosis and management of patients with reflux symptoms refractory to proton pump inhibitors. Gut. 2012;61:1340–54. In this review, that address very completely the management of GERD patients unresponsive to PPI therapy, the Authors provide a clear definition of PPI-refractory reflux symptoms.

4. Kahrilas PJ, Boeckstaens G. Failure of reflux inhibitors in clinical trials: bad drugs or wrong patients? Gut. 2012;61:1501–9. This paper provides a summary of PPI efficacy in patients with different manifestations of GERD. The results are expressed in terms of therapeutic gain in comparison with placebo and clearly indicate that the greatest PPI success occurred in patients with esophagitis or typical reflux symptoms.

5. Poh CH, Gasiorowska A, Navarro-Rodriguez T, Willis MR, Hargadon D, Noelck N, et al. Upper GI tract findings in patients with heartburn in whom proton pump inhibitor treatment failed versus those not receiving antireflux treatment. Gastrointest Endosc. 2010;71:28–34.

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