[Treatment strategy for GERD based on the recent evidence of the Japanese patients]

First line therapy for gastroesophageal reflux disease (GERD) has been considered to be an administration of a proton pump inhibitor (PPI) based on the clinical evidence developed in western countries. Gastric acid secretion of the Japanese is lower than those of western persons. Therefore, Japanese physicians hesitate to administer PPI in patients with GERD. Several high quality clinical studies have recently been done in Japan and they clearly indicate that PPI is the most powerful and appropriate first line therapeutic drug for patients with reflux esophagitis as well as non-erosive reflux disease. PPIs most effectively heal esophageal mucosal breaks, alleviate reflux symptoms, and improve health-related quality of life of patients with GERD.