title: Overview of medical therapy for gastroesophageal reflux disease.
abstract: There appears to be a hierarchy in the efficacy of therapies that are directed against GERD. A summary of this hierarchy, including therapies [table: see text] not approved by the U.S. Food and Drug Administration, is presented in Table 4. The individual practitioner must evaluate the appropriate point at which to place each patient on this hierarchy. Whether it is best to begin with the drug with the highest efficacy and step-down as possible for maintenance, never to step down, or to start with a less efficacious therapy and step up must also be individualized because there are no clear data to support a universal approach to all or even most GERD patients.
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic Jacksonville, Florida, USA. devault@mayo.edu
authors.forename: K R
authors.initials: KR
authors.lastname: DeVault
mesh_terms: D000863:Antacids / Q000627:therapeutic use; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D005764:Gastroesophageal Reflux / Q000188:drug therapy*; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans
chemical_list: D000863:Antacids; D004791:Enzyme Inhibitors; D006635:Histamine H2 Antagonists