Proton-pump inhibitor therapy in patients with gastro-oesophageal reflux disease: putative mechanisms of failure.
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.
Section of Gastroenterology, The Neuro-Enteric Clinical Research Group, Southern Arizona VA Health Care System, Tucson, Arizona 85723-0001, USA. Ronnie.fass@va.gov
Ronnie
R
Fass
D005744:Gastric Acid / Q000502:physiology; D005745:Gastric Acidity Determination; D005746:Gastric Emptying; D005764:Gastroesophageal Reflux / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000503:physiopathology; D054328:Proton Pump Inhibitors; D013315:Stress, Psychological / Q000150:complications; D017211:Treatment Failure
D054328:Proton Pump Inhibitors