Management of the patient with incomplete response to PPI therapy
PJ Kahrilas, G Boeckxstaens, AJPM Smout - Best practice & research …, 2013 - Elsevier
Proton pump inhibitors (PPIs) remove most of the acid from the gastroesophageal refluxate.
However, PPIs do not eliminate reflux and the response of specific GERD symptoms to PPI
therapy depends on the degree to which acid drives those symptoms. PPIs are progressively
less effective for heartburn, regurgitation, chest pain and extra-oesophageal symptoms.
Hence, with an incomplete PPI response, obtaining an accurate history, detailing which
symptoms are 'refractory'and exactly what evidence exists linking these symptoms to GERD …
However, PPIs do not eliminate reflux and the response of specific GERD symptoms to PPI
therapy depends on the degree to which acid drives those symptoms. PPIs are progressively
less effective for heartburn, regurgitation, chest pain and extra-oesophageal symptoms.
Hence, with an incomplete PPI response, obtaining an accurate history, detailing which
symptoms are 'refractory'and exactly what evidence exists linking these symptoms to GERD …