Drugs

, Volume 71, Issue 18, pp 2381–2389 | Cite as

Gastro-Oesophageal Reflux Disease

Beyond Proton Pump Inhibitor Therapy
Current Opinion

Abstract

Gastro-oesophageal reflux disease (GORD or GERD) is a very common disorder, and advancement in drug development over the years has markedly improved disease management. Proton pump inhibitors (PPIs) remain the mainstay of treatment for GERD due to their profound and consistent inhibitory effect on acid secretion. However, PPIs do not reduce the number of reflux events and do not provide long-term cure for GERD. In addition, although the safety profile of PPIs is excellent, recent population-based studies have suggested that long-term PPI use may be associated with a variety of adverse events. They include osteoporosis-related hip and spine fractures, community-acquired and nosocomial pneumonia, various enteric and non-enteric infections, fundic gland polyps and many others. Consequently, there is growing interest by patients and physicians alike in current, as well as future, non-PPI-related therapeutic strategies for GERD. This includes repositioning histamine H2 receptor antagonists and prokinetics in our current GERD therapeutic algorithms and a resurgence of non-medical therapeutic modalities for GERD, such as anti-reflux surgery, endoscopic treatment, alternative and complementary medicine and psychological interventions. Furthermore, there will be renewed efforts in further developing new medical and non-medical therapeutic modalities for GERD.

Notes

Acknowledgements

Dr Fass has received research support from AstraZeneca and Reckitt-Benckiser and served as a speaker for Takeda, and as a consultant for Shire, Takeda, Vecta and Reckitt-Benckiser. Dr Hershcovici has no conflicts of interest that are directly relevant to the content of this article. No sources of funding were used in the preparation of this article.

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© Adis Data Information BV 2011

Authors and Affiliations

  1. 1.Southern Arizona VA Health Care SystemTucsonUSA
  2. 2.Department of Medicine, Section of GastroenterologyUniversity of ArizonaTucsonUSA

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