[Medication therapeutic strategies for gastro-esophageal reflux disease]

Gastroesophageal reflux disease (GERD) is a common condition in industrialised countries. According to a recently published, globally accepted definition and classification of GERD, clinical presentations include oesophageal and extraoesophageal syndromes, with extraoesophageal syndromes divided into established and proposed associations. Proton pump inhibitors (PPI) are the drug class of choice for all patients with GERD, irrespective of the severity. The individual strategy of treatment (e. g., dose and duration of PPI) depends on the clinical presentation. As a rule, the magnitude of acid control gained by PPIs is related to clinically meaningful outcome parameters: speed and extent of symptom control, healing of reflux oesophagitis, maintenance of symptomatic and endoscopic remission of the disease. In individual cases, the efficacy of PPI therapy can be improved by switching from one compound to another and by increasing the frequency of dosing. Current evidence suggests that PPI therapy is remarkably safe without any relevant differences between the PPIs on the market.