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

Putative Mechanisms of Failure

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Abstract

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.

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Authors and Affiliations

  1. Section of Gastroenterology, The Neuro-Enteric Clinical Research Group, Southern Arizona VA Health Care System, 3601 S. 6th Avenue, Tucson, Arizona, 85723-0001, USA

    Ronnie Fass

  2. University of Arizona Health Sciences Center, Tucson, Arizona, USA

    Ronnie Fass

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Fass, R. Proton-Pump Inhibitor Therapy in Patients with Gastro-Oesophageal Reflux Disease. Drugs 67, 1521–1530 (2007). https://doi.org/10.2165/00003495-200767110-00001

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