PMID- 15630919
OWN - NLM
STAT- MEDLINE
DCOM- 20050210
LR  - 20051116
IS  - 0300-8495 (Print)
IS  - 0300-8495 (Linking)
VI  - 33
IP  - 12
DP  - 2004 Dec
TI  - Gastro-oesophageal reflux disease--current concepts in management.
PG  - 987-91
AB  - BACKGROUND: Gastro-oesophageal reflux disease (GORD) is defined as recurring 
      symptoms or mucosal damage resulting from exposure of the distal oesophagus to 
      reflux of gastric contents. In the past, GORD has been managed with a 'step up' 
      approach beginning with antacids and progressing to H2 antagonists or proton pump 
      inhibitors (PPI) as required. OBJECTIVE: This article presents a systematic 
      approach to the management of GORD. DISCUSSION: Diagnosis of GORD is made on the 
      basis of symptoms and the decision to treat is based on the symptom pattern. 
      Endoscopy is reserved for cases where there are alarm symptoms, diagnostic 
      uncertainty, poor response to treatment or clinical suspicion of a complication 
      such as Barrett's oesophagus or stricture. A 'step down' approach to treatment 
      involves treating with a PPI for 4-8 weeks. Aggressive therapy is then reduced to 
      maintenance doses, intermittent therapy or in some cases, withdrawn. However, 
      relapse occurs in about 70% of all patients within 6 months. A step down approach 
      ensures more rapid resolution of symptoms, improved quality of life, reduced risk 
      of complications, and overall lower cost.
FAU - Piterman, Leon
AU  - Piterman L
AD  - Monash University Department of General Practice, Melbourne, Victoria. 
      leon.piteman@med.monash.edu.au
FAU - Nelson, Mark
AU  - Nelson M
FAU - Dent, John
AU  - Dent J
LA  - eng
PT  - Journal Article
PT  - Review
PL  - Australia
TA  - Aust Fam Physician
JT  - Australian family physician
JID - 0326701
RN  - 0 (Anti-Ulcer Agents)
SB  - IM
MH  - Anti-Ulcer Agents/therapeutic use
MH  - Barrett Esophagus/diagnosis/etiology/therapy
MH  - Clinical Protocols
MH  - Family Practice/*methods
MH  - Gastroesophageal Reflux/complications/*diagnosis/*therapy
MH  - Humans
RF  - 16
EDAT- 2005/01/06 09:00
MHDA- 2005/02/11 09:00
CRDT- 2005/01/06 09:00
PHST- 2005/01/06 09:00 [pubmed]
PHST- 2005/02/11 09:00 [medline]
PHST- 2005/01/06 09:00 [entrez]
PST - ppublish
SO  - Aust Fam Physician. 2004 Dec;33(12):987-91.