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Related Experiment Videos

GERD 2004: issues from the past and a consensus for the future.

Irvin Modlin1, Mark Kidd

  • 1Department of Surgery, Yale University School of Medicine, 333 Cedar St, New Haven, CT 06520-8062, USA. imodlin@optonline.net

Best Practice & Research. Clinical Gastroenterology
|December 14, 2004
PubMed
Summary

Gastroesophageal reflux disease (GERD) management has evolved from ineffective treatments to proton pump inhibitors (PPIs), now the standard of care. Further research is needed for associated mucosal changes like Barrett

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Area of Science:

  • Gastroenterology and Pharmacology

Background:

  • Gastroesophageal reflux disease (GERD) prevalence has surged globally, with early treatments offering limited efficacy.
  • Histamine H2 receptor antagonists improved GERD management but faced limitations like tachyphylaxis and adverse events.

Observation:

  • Proton pump inhibitors (PPIs) revolutionized GERD treatment due to their high efficacy and safety profile.
  • Surgical interventions for GERD have declined due to operator dependency, high morbidity, and mortality rates.
  • All PPIs demonstrate comparable efficacy on a milligram-per-milligram basis for GERD management.

Findings:

  • Pharmacological therapy, particularly PPIs, is recognized as the gold standard for GERD treatment.
  • A consensus exists on PPIs as the safest and most effective therapy for GERD.

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Implications:

  • Significant gaps remain in understanding the biological basis and regulation of GERD-associated mucosal metaplasia.
  • Future research should focus on early detection of Barrett's esophagus, identifying neoplastic transformation markers, and establishing therapeutic algorithms.