Proton pump inhibitor resistance, the real challenge in gastro-esophageal reflux disease Full Text
World Journal of Gastroenterology,  Clinical Article

Cicala M, et al. – Gastro-esophageal reflux disease (GERD) is one of the most prevalent chronic diseases. Although proton pump inhibitors (PPIs) represent the mainstay of treatment both for healing erosive esophagitis and for symptom relief, several studies have shown that up to 40% of GERD patients reported either partial or complete lack of response of their symptoms to a standard PPI dose once daily. Patients with proven disease, not responding to PPI twice daily, are eligible for anti–reflux surgery.

Methods

  • Several mechanisms have been proposed as involved in PPIs resistance, including ineffective control of gastric acid secretion, esophageal hypersensitivity, ultrastructural and functional changes in the esophageal epithelium.
  • The diagnostic evaluation of a refractory GERD patients should include an accurate clinical evaluation, upper endoscopy, esophageal manometry and ambulatory pH-impedance monitoring, which allows to discriminate non-erosive reflux disease patients from those presenting esophageal hypersensitivity or functional heartburn.
  • Treatment has been primarily based on doubling the PPI dose or switching to another PPI.

Please login or register to follow this author.
Are you sure you want to Unfollow this Author?
► Click here to access Full Text, PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Gastroenterology

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Gastroenterology Articles

1 Screening prior to biological therapy in Crohn's disease: Adherence to guidelines and prevalence of infections. Results from a multicentre retrospective study Digestive and Liver Diseases, August 4, 2014    Clinical Article

2 A prospective, randomized, controlled, exploratory study of comprehensive dietary advice in ulcerative colitis: impact on disease activity and quality of life European Journal of Gastroenterology & Hepatology, July 10, 2014    Clinical Article

3 Fecal lactoferrin in discriminating inflammatory bowel disease from irritable bowel syndrome: A diagnostic meta-analysis Full Text BMC Gastroenterology, July 14, 2014    Free full text    Evidence Based Medicine

4 Bolus administration of steroid therapy is more favorable than the conventional use in preventing decrease of bone density and the increase of body fat percentage in patients with inflammatory bowel disease Journal of Crohn's and Colitis, August 22, 2014    Clinical Article

5 The impact of preoperative steroid use on short-term outcomes following surgery for inflammatory bowel disease Journal of Crohn's and Colitis, August 8, 2014    Clinical Article

6 Prognostic effect of p53 expression in patients with completely resected colorectal cancer Tumor Biology, July 18, 2014    Clinical Article

7 Proton pump inhibitor use significantly increases the risk of spontaneous bacterial peritonitis in 1965 patients with cirrhosis and ascites: a propensity score matched cohort study Alimentary Pharmacology and Therapeutics, August 1, 2014    Clinical Article

8 Risk of drug-induced liver injury from tumor necrosis factor antagonists Clinical Gastroenterology and Hepatology , August 25, 2014    Clinical Article

9 Inflammatory bowel disease and cervical neoplasia: a population-based nationwide cohort study Clinical Gastroenterology and Hepatology , August 14, 2014    Clinical Article

10 Colesevelam for the treatment of bile acid malabsorption-associated diarrhea in patients with Crohn's disease: A randomized, double-blind, placebo-controlled study Journal of Crohn's and Colitis, August 27, 2014    Clinical Article

11 Risk of lymphoma in patients with inflammatory bowel disease treated with azathioprine and 6-mercaptopurine: a meta-analysis Clinical Gastroenterology and Hepatology , June 25, 2014    Evidence Based Medicine    Clinical Article

12 Magnetic resonance enterography, small-intestine contrast US, and capsule endoscopy to evaluate the small bowel in pediatric Crohn's disease: A prospective, blinded, comparison study Gastrointestinal Endoscopy, August 18, 2014    Clinical Article

13 The vitamin D status in inflammatory bowel disease PLOS ONE, July 18, 2014    Clinical Article
Exclusive Author Commentary

14 Moxibustion and acupuncture for the treatment of Crohn’s disease Full Text World Journal of Gastroenterology, August 29, 2014    Free full text    Clinical Article

15 Once versus three times daily dosing of oral budesonide for active Crohn's disease: A double-blind, double-dummy, randomised trial Journal of Crohn's and Colitis, August 28, 2014    Clinical Article

16 Comparing omeprazole with fluoxetine for treatment of patients with heartburn and normal endoscopy who failed once daily proton pump inhibitors: Double-blind placebo-controlled trial Neurogastroenterology & Motility, February 10, 2014    Clinical Article

17 An accelerated infliximab induction regimen reduces the need for early colectomy in patients with acute severe ulcerative colitis Clinical Gastroenterology and Hepatology , August 6, 2014    Clinical Article

18 Increased risk of venous thromboembolic events with corticosteroid vs biologic therapy for inflammatory bowel disease Clinical Gastroenterology and Hepatology , July 25, 2014    Clinical Article

19 Factors associated with pregnancy outcome in anti-TNF treated women with inflammatory bowel disease Alimentary Pharmacology and Therapeutics, July 3, 2014    Clinical Article

20 Subcutaneous ustekinumab for the treatment of anti-TNF resistant Crohn's disease-The McGill experience Journal of Crohn's and Colitis, July 9, 2014    Clinical Article

Indexed Journals in Gastroenterology: Gastroenterology, American Journal of Gastroenterology, Gutmore

Register now to view all the MDLinx contents (FREE)!

  • Stay current on the latest literature, research and clinical news
  • Get special communications and offers from MDLinx and our sponsors
  • Receive invitations to paid market research
View Samples and Register

Connect with us, stay current.

Receive the latest mecial news
updates for free via email

Sign up!

Subscribe to our free RSS feeds:

Get the latest news in your specialty automatically added to your newsreader or your personal My Yahoo!, Google, My MSN or My AOL page. Learn More

Close