Management of gastroesophageal reflux disease

Gastroesophageal reflux disease (GERD) is a frequent clinical condition which leads to reduced quality of life. Atypical manifestations of the disease can confound diagnosis, and even the typical symptoms of heartburn and regurgitation can lead to misinterpretation. Proton pump inhibitors (PPIs) are the standard treatment for GERD and the different formulations show equivalence on a milligram to milligram basis in terms of efficacy and tolerability. With standard dosing, 8 weeks of treatment has been shown to heal most patients. However, as GERD is a chronically relapsing disease, maintenance treatment with lower dose PPIs is frequently required. Pantoprazole is the only PPI found not to interact with the metabolism of other drugs and is therefore the treatment of choice especially for patients with co-morbidities and co-medication.