PMID- 19417644
OWN - NLM
STAT- MEDLINE
DCOM- 20090902
LR  - 20220310
IS  - 1531-7056 (Electronic)
IS  - 0267-1379 (Linking)
VI  - 25
IP  - 4
DP  - 2009 Jul
TI  - Evolving issues in the management of reflux disease?
PG  - 342-51
LID - 10.1097/MOG.0b013e32832c1504 [doi]
AB  - PURPOSE OF REVIEW: Gastroesophageal reflux disease (GERD) is a common chronic 
      disorder often successfully treated, although there are several evolving issues 
      in management. We reviewed the issues related to unmet needs over the past 12 
      months. RECENT FINDINGS: A substantial number of patients fail to respond 
      adequately to once or even twice daily proton pump inhibitor (PPI). There is no 
      standard definition of PPI failure in GERD; a universally accepted definition for 
      treatment success is also not available. Differentiation between erosive 
      esophagitis and nonerosive reflux disease can be made but requires endoscopy; but 
      studies still confuse functional heartburn and nonerosive reflux disease, which 
      impacts management. Acid reflux plays an important role in GERD pathogenesis and 
      the precise role of acid requires more studies of differences between erosive 
      esophagitis and nonerosive reflux disease symptom generation and the implication 
      of nocturnal acidification. Several possible mechanisms may explain GERD 
      refractory to PPIs. SUMMARY: Management of PPI nonresponders remains a challenge. 
      Objective and precise evaluation of symptoms and treatment response requires 
      study in high-quality trials. New therapeutic approaches are under investigation 
      to answer unmet needs and improve erosive esophagitis healing rates and symptom 
      control.
FAU - Yuan, Yuhong
AU  - Yuan Y
AD  - Department of Medicine, Division of Gastroenterology, McMaster University Health 
      Science Centre, Hamilton, Canada.
FAU - Hunt, Richard H
AU  - Hunt RH
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Curr Opin Gastroenterol
JT  - Current opinion in gastroenterology
JID - 8506887
RN  - 0 (Anti-Ulcer Agents)
RN  - 0 (Delayed-Action Preparations)
RN  - 0 (Drugs, Investigational)
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Anti-Ulcer Agents/administration & dosage
MH  - Delayed-Action Preparations
MH  - Drug Resistance
MH  - Drugs, Investigational/pharmacology
MH  - Esophageal pH Monitoring
MH  - Esophagitis, Peptic/*prevention & control
MH  - Esophagoscopy
MH  - Female
MH  - Follow-Up Studies
MH  - Gastric Acidity Determination
MH  - Gastric Mucosa/drug effects/pathology
MH  - Gastroesophageal Reflux/*drug therapy/*pathology/physiopathology
MH  - Humans
MH  - Male
MH  - Proton Pump Inhibitors/*administration & dosage
MH  - Randomized Controlled Trials as Topic
MH  - Recurrence
MH  - Risk Assessment
MH  - Severity of Illness Index
MH  - Treatment Outcome
RF  - 106
EDAT- 2009/05/07 09:00
MHDA- 2009/09/03 06:00
CRDT- 2009/05/07 09:00
PHST- 2009/05/07 09:00 [entrez]
PHST- 2009/05/07 09:00 [pubmed]
PHST- 2009/09/03 06:00 [medline]
AID - 10.1097/MOG.0b013e32832c1504 [doi]
PST - ppublish
SO  - Curr Opin Gastroenterol. 2009 Jul;25(4):342-51. doi: 
      10.1097/MOG.0b013e32832c1504.