Pharmacotherapy for chronic gastro-oesophageal reflux disease and Barrett's oesophagus.
Over the last two decades there have been major advances in the medical treatment of gastro-oesophageal reflux disease (GORD) and Barrett's oesophagus. Motility agents, H(2)-receptor antagonists and proton-pump inhibitors (PPI) have all been evaluated in short- and long-term studies. Symptomatic response needs to be differentiated from healing of oesophagitis and maintenance of remission. Clinical trials have convincingly demonstrated the superiority of PPIs to motility agents and H(2)-receptor antagonists for all clinical aspects of GORD. Barrett's oesophagus requires lifelong acid suppression. Treatment with standard doses of PPIs is often insufficient and higher doses are frequently required. Medical treatment does not appear to result in clinically significant regression of Barrett's oesophagus.
Wurm
Peter
P
Digestive Diseases Centre, Royal Leicester Infirmary, LE1 5WW, UK. peter.wurm@uhl-tr.nhs.uk
de Caestecker
John
J
D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D001471:Barrett Esophagus / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D002908:Chronic Disease; D017850:Economics, Pharmaceutical; D005764:Gastroesophageal Reflux / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D006635:Histamine H2 Antagonists / Q000627:therapeutic use*; D006801:Humans; D008019:Life Style; D054328:Proton Pump Inhibitors
D000897:Anti-Ulcer Agents; D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors