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[Reflux disease therapy].

H D Allescher1

  • 1Zentrum für Innere Medizin, Gastroenterologie, Hepatologie und Stoffwechsel, Klinikum Garmisch-Partenkirchen. hans.allescher@klinikum-gap.de

Praxis
|January 20, 2005
PubMed
Summary
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Proton pump inhibitors (PPIs) effectively treat erosive reflux esophagitis and prevent recurrence in over 90% of patients. Long-term PPI therapy is generally safe and essential for most patients due to high recurrence rates without treatment.

Area of Science:

  • Gastroenterology
  • Internal Medicine
  • Pharmacology

Background:

  • Gastroesophageal reflux disease (GERD) is increasingly prevalent in Western countries.
  • GERD management includes acute treatment and recurrence prophylaxis for erosive esophagitis, non-erosive disease, and atypical symptoms.

Purpose of the Study:

  • To review the efficacy and safety of proton pump inhibitors (PPIs) in GERD management.
  • To discuss alternative and long-term therapeutic strategies for GERD.

Main Methods:

  • Review of large-scale studies on PPI therapy for GERD.
  • Analysis of recurrence rates and side effect profiles of PPIs.
  • Evaluation of alternative treatments like laparoscopic fundoplication and endoscopic procedures.

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Main Results:

  • Proton pump inhibitors (PPIs) achieve near-complete acid blockade, offering symptom relief and healing in approximately 90% of acute erosive reflux esophagitis cases.
  • PPIs demonstrate high efficacy in preventing recurrence, with a low rate of serious side effects and good long-term safety.
  • Without PPI therapy, the risk of erosive reflux esophagitis recurrence exceeds 80%, necessitating long-term or lifelong treatment for most patients.

Conclusions:

  • PPIs are highly effective for acute GERD treatment and long-term prophylaxis, with a favorable safety profile.
  • Alternative therapies, including surgical and endoscopic procedures, are emerging but require further evaluation for long-term efficacy.
  • Patients experiencing persistent symptoms despite PPI therapy, including those with atypical reflux symptoms, should be considered for alternative treatment approaches.