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Evolving issues in the management of reflux disease?
1Department of Medicine, Division of Gastroenterology, McMaster University Health Science Centre, Hamilton, Canada.
Current Opinion in Gastroenterology
|May 7, 2009
Summary
Many patients with gastroesophageal reflux disease (GERD) do not respond to proton pump inhibitors (PPIs). New treatments are needed to manage PPI nonresponders and improve healing and symptom control for GERD.
Area of Science:
- Gastroenterology
- Pharmacology
- Clinical Medicine
Background:
- Gastroesophageal reflux disease (GERD) is a prevalent chronic condition with established treatments.
- However, evolving management issues and unmet needs persist, particularly concerning treatment efficacy.
Purpose of the Study:
- To review current challenges and unmet needs in the management of GERD over the past 12 months.
- To identify gaps in understanding and treatment for patients with GERD.
Main Methods:
- Literature review focusing on recent advancements and persistent issues in GERD management.
- Analysis of studies addressing proton pump inhibitor (PPI) efficacy and patient response.
Main Results:
- A significant portion of GERD patients exhibit inadequate response to standard proton pump inhibitor (PPI) therapy.
- Lack of standardized definitions for PPI failure and treatment success complicates GERD management.
- Distinguishing between erosive esophagitis and nonerosive reflux disease, and functional heartburn, remains challenging and impacts therapeutic strategies.
Conclusions:
- Managing GERD patients who do not respond to PPIs presents a significant clinical challenge.
- High-quality trials are essential for objective evaluation of symptoms and treatment outcomes.
- Investigational therapies aim to address unmet needs, improve healing rates for erosive esophagitis, and enhance symptom control.
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