Proton-Pump Inhibitor Therapy in Patients with Gastro-Oesophageal Reflux Disease: Putative Mechanisms of Failure

Author: Fass, Ronnie

Source: Drugs, Volume 67, Number 11, 2007 , pp. 1521-1530(10)

Publisher: Adis International

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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.

Keywords: Gastro oesophageal reflux; Proton pump inhibitors

Document Type: Research article

Publication date: 2007-01-01

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