PMID- 15478853
OWN - NLM
STAT- MEDLINE
DCOM- 20041104
LR  - 20220330
IS  - 0002-9343 (Print)
IS  - 0002-9343 (Linking)
VI  - 117 Suppl 5A
DP  - 2004 Sep 6
TI  - Managing gastroesophageal reflux disease for the lifetime of the patient: 
      evaluating the long-term options.
PG  - 49S-55S
AB  - Lifetime management goals of gastroesophageal reflux disease (GERD) are to 
      control esophageal as well as extraesophageal symptoms, maintain a stable 
      noninflamed esophageal mucosa, and prevent complications. Large randomized 
      clinical trials and >16 years of worldwide experience have confirmed the high 
      rate of efficacy and excellent safety profile of proton pump inhibitor (PPI) 
      therapy in individuals with all grades of GERD, making these agents the mainstay 
      of treatment. Despite these outcomes, some individuals may desire an alternative 
      to pharmacologic therapy. In such patients, laparoscopic fundoplication may 
      produce symptom relief and healing of esophagitis, but its invasiveness, cost, 
      and inherent surgical risks have created an interest in a variety of endoscopic 
      therapies for reflux disease. Several short-term uncontrolled trials of these 
      endoscopic therapies have reported encouraging preliminary results; however, 
      careful patient selection as well as clinician experience is critical for their 
      success. In addition to clinician expertise with the procedure, success has been 
      observed only in patients with nonerosive GERD and a hiatal hernia <3 cm, 
      abnormal pH monitoring, and normal esophageal motility studies, as well as in 
      those who have experienced at least partial symptom relief with PPI therapy. 
      Endoscopic therapy should not be considered the standard of care in patients with 
      erosive disease or large hiatal hernias.
FAU - Metz, David C
AU  - Metz DC
AD  - Department of Gastroenterology, Hospital of University of Pennsylvania, 
      Philadelphia, Pennsylvania 19104-4283, USA.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Am J Med
JT  - The American journal of medicine
JID - 0267200
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Dose-Response Relationship, Drug
MH  - Drug Administration Schedule
MH  - Evaluation Studies as Topic
MH  - Female
MH  - Fundoplication/methods
MH  - Gastroesophageal Reflux/diagnosis/*drug therapy/*surgery
MH  - Humans
MH  - Long-Term Care
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - *Proton Pump Inhibitors
MH  - Randomized Controlled Trials as Topic
MH  - Severity of Illness Index
RF  - 49
EDAT- 2004/10/14 09:00
MHDA- 2004/11/05 09:00
CRDT- 2004/10/14 09:00
PHST- 2004/10/14 09:00 [pubmed]
PHST- 2004/11/05 09:00 [medline]
PHST- 2004/10/14 09:00 [entrez]
AID - S1548-2766(04)00009-3 [pii]
AID - 10.1016/j.amjmed.2004.07.009 [doi]
PST - ppublish
SO  - Am J Med. 2004 Sep 6;117 Suppl 5A:49S-55S. doi: 10.1016/j.amjmed.2004.07.009.