Optimising acid inhibition treatment.
Acid inhibition is safe and useful in several clinical settings. Proton pump inhibitors are more effective than H2-receptor antagonists in virtually all cases. Proton pump inhibitors should be used in: the eradication of Helicobacter pylori; the treatment of non-H. pylori-related peptic ulcer healing; for the prevention and treatment of non-steroidal anti-inflammatory drug-induced upper digestive lesions; for bleeding peptic lesions; and, especially, in the short-term and long-term control of gastro-oesophageal reflux disease. The timing, the dosing and the specific drugs should be adapted to the particular patient, clinical situation and local factors. For instance, in a patient with active bleeding from a duodenal ulcer, intravenous constant infusion should be the preferred treatment. When seeking oral 'potent' acid inhibition (refractory gastro-oesophageal reflux disease, and perhaps Barrett's oesophagus), available data suggest that the pharmacological and clinical profiles of esomeprazole are slightly better.
Gomollón
Fernando
F
Facultad de Medicina, Gastroenterology Service, Clinical University Hospital, Zaragoza, Spain. fgomollon@gmail.com
Calvet
Xavier
X
D000897:Anti-Ulcer Agents / Q000008:administration & dosage*; D064098:Esomeprazole / Q000008:administration & dosage*; D005744:Gastric Acid / Q000378:metabolism*; D006801:Humans; D010437:Peptic Ulcer / Q000188:drug therapy*; D054328:Proton Pump Inhibitors
D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors; D064098:Esomeprazole