GERD 2003: issues from the past and a consensus for the future.
Gastroesophageal reflux disease (GERD) has evolved from a scarcely reported, little understood disease process just a century ago to a now highly prevalent disease with up to 25% of the population complaining of symptoms of reflux. Throughout history attempts have been made to delineate the esophagus and related pathologies, but it has not been until relatively recently that enough has been understood about its screening, diagnosis and treatment to make a substantial impact on sufferers. Although the use of antacids and thereafter histamine 2 receptor antagonists dramatically improved the management of GERD, it was the advent of the proton pump inhibitor (PPI) class of drugs that revolutionized medical care. Although the relationship of hiatus hernia to reflux was well accepted, the modest results of open fundoplication fell into further disregard given the efficacy of PPIs. The PPIs are currently the most effective form of therapy and are equivalent on a milligram for milligram basis. While currently no novel drugs or devices are of proven efficacy for GERD, the development of an acid-suppressive agent of equal efficiency to a PPI but with a more rapid onset of action and a greater duration of effectiveness would be of particular clinical utility for the future.
Modlin
Irvin
I
Gastric Pathology Research Group, Department of Surgery, Yale University, School of Medicine, New Haven, CT 06520-8062, USA.
Kidd
Mark
M
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents / Q000266:history* / Q000627:therapeutic use; D001562:Benzimidazoles / Q000266:history* / Q000627:therapeutic use; D004942:Esophagitis, Peptic / Q000266:history / Q000628:therapy; D005764:Gastroesophageal Reflux / Q000266:history* / Q000628:therapy; D049672:History, 19th Century; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D009853:Omeprazole / Q000266:history* / Q000627:therapeutic use; D000077402:Pantoprazole; D011183:Postoperative Complications; D054328:Proton Pump Inhibitors; D013454:Sulfoxides / Q000266:history* / Q000627:therapeutic use
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D001562:Benzimidazoles; D054328:Proton Pump Inhibitors; D013454:Sulfoxides; D000077402:Pantoprazole; D009853:Omeprazole