Healing, relapse rates and prophylaxis of reflux esophagitis

Gastroesophageal reflux is a daily occurrence in the general population. Reflux esophagitis is less common but still a considerable clinical problem. The results of medical therapy are generally clearly inferior to those seen in peptic ulcer disease. After healing relapse is rapid and maintenance has not been proved superior to placebo. The promising results with omeprazole (inducing pronounced acid inhibition) and surgery (strengthening anti-reflux mechanisms) indicate that a more aggressive approach may be needed in future treatment. Additional studies also using combinations of drugs both in the healing stage and during maintenance is needed. These should be compared to the long-term results of surgery.