Review article: the unmet needs in delayed-release proton-pump inhibitor therapy in 2005

Proton-pump inhibitors have been highly effective in managing acid-related gastrointestinal disorders, but challenges remain. This paper reviews the challenges in the management of patients with gastro-oesophageal symptoms who do not respond adequately to proton-pump inhibitor therapy; the treatment of patients with non-variceal upper gastrointestinal bleeding; the prevention of stress-related mucosal bleeding; the treatment and prevention of non-steroidal anti-inflammatory drug-related gastrointestinal injury; and the optimal combination of antisecretory and antibiotic therapy for the eradication of Helicobacter pylori infection, all of which represent unmet clinical needs. Antisecretory therapy with a rapid onset of action and sustained antisecretory effect may help to address some of the unmet needs discussed, especially in the management of gastro-oesophageal reflux disease, non-variceal upper gastrointestinal bleeding and non-steroidal anti-inflammatory drug-related gastrointestinal complications.