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Updated: Feb 5, 2026

Single Liposome Measurements for the Study of Proton-Pumping Membrane Enzymes Using Electrochemistry and Fluorescent Microscopy
Published on: February 21, 2019
Refractory GERD, beyond proton pump inhibitors
1Université de Lyon, Hospices Civils de Lyon, Digestive Physiology, Hopital E Herriot, F-69437, Lyon, France; Université de Lyon, Lyon I University, Digestive Physiology, F-69008, Lyon, France; Université de Lyon, Inserm U1032, LabTAU, F-69008, Lyon, France.
Abstract:
Pharmacologic therapy, surgery, minimally invasive therapies, and alternative therapies are different options available for the management of refractory GERD. The choice may depend on the cause of refractoriness. Increased gastric acid suppression therapy might be useful in the rare patients with persistent elevated esophageal acid exposure on proton pump inhibitors (PPI). Potassium-competitive acid blockers (P-CAB) might induce a more important acid inhibition than PPI. Baclofen might act as a reflux inhibitor and demonstrates a significant efficacy in rumination syndrome. The role of topical antacid-alginate in refractory GERD might be limited. Surgery might be a valid option in case of persistent pathological acid esophageal exposure despite PPI. Further evaluation of minimally invasive procedures is necessary. Finally diet, diaphragmatic breathing and transcutaneous electrical acustimulation might be of interest in patients with esophageal hypersensivity or functional symptoms.
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