, Volume 67, Issue 11, pp 1521–1530

Proton-Pump Inhibitor Therapy in Patients with Gastro-Oesophageal Reflux Disease

Putative Mechanisms of Failure
Current Opinion

DOI: 10.2165/00003495-200767110-00001

Cite this article as:
Fass, R. Drugs (2007) 67: 1521. doi:10.2165/00003495-200767110-00001


Proton-pump inhibitor (PPI) failure in gastro-oesophageal reflux disease (GORD) patients has become the main reason for referral of these patients to gastroenterology specialists. It is estimated that 30% of GORD patients requiring a PPI once daily will experience treatment failure. Patients with non-erosive reflux disease are the most common GORD-related group in which once-daily PPI therapy fails. Various mechanisms have been suggested to underlie PPI failure in GORD patients. The most pertinent include weakly acidic reflux, duodenogastro-oesophageal reflux, visceral hyperalgesia, delayed gastric emptying, psychological co-morbidity and concomitant functional bowel disorders, as well as others. Because of the importance of PPI failure as a target for future drug development, further understanding of the most relevant underlying mechanisms is needed.

Copyright information

© Adis Data Information BV 2007

Authors and Affiliations

  1. 1.Section of GastroenterologyThe Neuro-Enteric Clinical Research Group, Southern Arizona VA Health Care SystemTucsonUSA
  2. 2.University of Arizona Health Sciences CenterTucsonUSA