Evaluation and Treatment of Patients with Persistent Reflux Symptoms Despite Proton Pump Inhibitor Treatment

Research output: Contribution to journalReview article

Abstract

Despite the exceptional efficacy of proton pump inhibitors (PPIs) in healing reflux esophagitis complicating gastroesophageal reflux disease (GERD), up to 40% of patients who take PPIs for GERD complain of persistent GERD symptoms. There is no clear consensus on the type, dosing, and duration of PPI therapy required to establish a diagnosis of PPI-refractory GERD symptoms, but most authorities do not consider patients “PPI-refractory” unless they have been on double-dose PPIs. This article discusses the mechanisms that might underlie heartburn that does not respond PPIs and an approach to the management of patients with PPI-refractory GERD symptoms.

Original languageEnglish (US)
Pages (from-to)437-450
Number of pages14
JournalGastroenterology Clinics of North America
Volume49
Issue number3
DOIs
StatePublished - Sep 2020
Externally publishedYes

Keywords

  • Functional heartburn
  • Fundoplication
  • Gastroesophageal reflux disease
  • Reflux hypersensitivity

ASJC Scopus subject areas

  • Gastroenterology

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