A significant percentage of patients with gastroesophageal reflux disease (GERD) will not respond to proton pump inhibitor (PPI) therapy. The causes of PPI-refractory GERD are numerous and diverse, and include adherence, persistent acid, functional disorders, nonacid reflux, and PPI bioavailability. The evaluation should start with a symptom assessment and may progress to imaging, endoscopy, and monitoring of esophageal pH, impedance, and bilirubin. There are a variety of pharmacologic and procedural interventions that should be selected based on the underlying mechanism of PPI failure. Pharmacologic treatments can include antacids, prokinetics, alginates, bile acid binders, reflux inhibitors, and antidepressants. Procedural options include laparoscopic fundoplication and LINX as well as endoscopic procedures, such as transoral incisionless fundoplication and Stretta. Several alternative and complementary treatments of possible benefit also exist.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5868737 | PMC |
| http://dx.doi.org/10.2147/CEG.S121056 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Approach to anaemia in gastrointestinal disease: A position paper by the ESPGHAN Gastroenterology Committee.
J Pediatr Gastroenterol Nutr
January 2025
Department of Paediatrics, University Medical Centre Maribor, Maribor, Slovenia.
Anaemia is a frequent consequence of many gastrointestinal (GI) diseases in children and it can even be the initial presenting symptom of underlying chronic GI disease. The definition of anaemia is age and gender-dependent and it can be classified based on pathophysiology, red cell morphology, and clinical presentation. Although nutritional deficiencies, including GI malabsorption of nutrients and GI bleeding, play a major role, other pathophysiologic mechanisms seen in chronic GI diseases, whether inflammatory (e.
View Article and Find Full Text PDFDrug Development.
Alzheimers Dement
December 2024
Institute of Science and Technology Austria (ISTA), Klosterneuburg, Austria.
Background: We identified small molecule tricyclic pyrone compound CP2 as a mild mitochondrial complex I (MCI) inhibitor that induces neuroprotection in multiple mouse models of AD. One of the major concerns while targeting mitochondria is the production of reactive oxygen species (ROS). CP2 consists of two diastereoisomers, D1 and D2, with distinct activity and toxicity profiles.
View Article and Find Full Text PDFConservative management of emphysematous esophagitis-a case report.
Mediastinum
July 2024
Department of Radiology, Inje University Sanggye Paik Hospital, Seoul, Korea.
Background: Emphysematous esophagitis is a very rare disease and there are only a few previous reports in the literature. Previously reported cases have resulted in emphysematous esophagitis following anterior cervical procedures or ingestion of hydrogen peroxide (HP). In this report, we describe a case in which a patient with emphysematous esophagitis accompanied by gastritis without the above predisposing factors was treated with conservative treatment.
View Article and Find Full Text PDFAn Outline on benzimidazole Containing Marketed Drugs with Proton Pump Inhibitor and H Receptor Antagonist Activities.
Mini Rev Med Chem
January 2025
Department of Chemistry, Kurukshetra University, Kurukshetra, Kurukshetra, 136119, India.
Heterocyclic compounds are increasingly used in medicinal chemistry because they are the main components of many biological processes and materials. Benzimidazole remains the core center of the heterocyclic chemical group, with essential traits such as six-five-member connected rings and two nitrogen atoms at the 1,3 position in a six-membered benzene and five-membered imidazole- fused ring system. Molecules with benzimidazole derivatives serve important functions as therapeutic agents and have shown excellent results in clinical and biological research.
View Article and Find Full Text PDFTrial of alginates in throat symptoms: protocol for a pragmatic, multicentre, placebo controlled, double blind, parallel, randomised controlled trial of liquid alginate (Gaviscon Advance) for the treatment of persistent throat symptoms.
BMJ Open
January 2025
Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, Tyne and Wear, UK
Introduction: Persistent throat symptoms (PTS) are indicators for over 60 000 new patient referrals to NHS secondary care annually. PTS have been attributed to manifestation of gastro-oesophageal reflux disease (GORD) with the hypothesis that gastric refluxate damages and irritates the mucosa of the upper aerodigestive tract. Symptoms of PTS and GORD are commonly treated with proton pump inhibitors (PPIs) or alginates are often, incorrectly, advocated.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!