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Management of severe gastroesophageal reflux disease.

Abstract

Gastroesophageal reflux disease (GERD) affects more than one third of the population. It is generally a chronic condition and has the potential to be serious. Some patients with GERD experience persistent daytime or nighttime heartburn and some sustain severe damage, including ulceration, stricture, and Barrett's esophagus, which can predispose to development of adenocarcinoma. Extraesophageal manifestations of GERD can include otolaryngologic, respiratory, and cardiac problems. Severe GERD responds best to agents that suppress gastric acid secretion. Of these, proton pump inhibitors (PPIs) provide the most effective control of gastric acidity and are, therefore, the medical treatment of choice. In fact, nonresponse to a PPI should raise the suspicion that the diagnosis is not GERD. Proton pump inhibitors are quickly becoming the treatment of choice for GERD, especially for severe or refractory cases. For patients whose GERD is refractory even to PPIs or who are unwilling to face years of PPI therapy, antireflux surgery remains an option.

Links

  • Publisher Full Text
  • Authors+Show Affiliations

    Division of Gastroenterology, University of South Alabama College of Medicine, Mobile 36693, USA. jdipalma@usamail.usouthal.edu

    Source

    MeSH

    Anti-Ulcer Agents
    Enzyme Inhibitors
    Esophageal Diseases
    Esophageal Neoplasms
    Esophagitis, Peptic
    Gastroesophageal Reflux
    Histamine H2 Antagonists
    Humans
    Models, Biological
    Proton Pump Inhibitors
    Risk Factors

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    11154163

    Citation

    DiPalma, J A.. "Management of Severe Gastroesophageal Reflux Disease." Journal of Clinical Gastroenterology, vol. 32, no. 1, 2001, pp. 19-26.
    DiPalma JA. Management of severe gastroesophageal reflux disease. J Clin Gastroenterol. 2001;32(1):19-26.
    DiPalma, J. A. (2001). Management of severe gastroesophageal reflux disease. Journal of Clinical Gastroenterology, 32(1), pp. 19-26.
    DiPalma JA. Management of Severe Gastroesophageal Reflux Disease. J Clin Gastroenterol. 2001;32(1):19-26. PubMed PMID: 11154163.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Management of severe gastroesophageal reflux disease. A1 - DiPalma,J A, PY - 2001/1/12/pubmed PY - 2001/5/22/medline PY - 2001/1/12/entrez SP - 19 EP - 26 JF - Journal of clinical gastroenterology JO - J. Clin. Gastroenterol. VL - 32 IS - 1 N2 - Gastroesophageal reflux disease (GERD) affects more than one third of the population. It is generally a chronic condition and has the potential to be serious. Some patients with GERD experience persistent daytime or nighttime heartburn and some sustain severe damage, including ulceration, stricture, and Barrett's esophagus, which can predispose to development of adenocarcinoma. Extraesophageal manifestations of GERD can include otolaryngologic, respiratory, and cardiac problems. Severe GERD responds best to agents that suppress gastric acid secretion. Of these, proton pump inhibitors (PPIs) provide the most effective control of gastric acidity and are, therefore, the medical treatment of choice. In fact, nonresponse to a PPI should raise the suspicion that the diagnosis is not GERD. Proton pump inhibitors are quickly becoming the treatment of choice for GERD, especially for severe or refractory cases. For patients whose GERD is refractory even to PPIs or who are unwilling to face years of PPI therapy, antireflux surgery remains an option. SN - 0192-0790 UR - https://www.unboundmedicine.com/medline/citation/11154163/Management_of_severe_gastroesophageal_reflux_disease_ L2 - http://Insights.ovid.com/pubmed?pmid=11154163 DB - PRIME DP - Unbound Medicine ER -