Refractory heartburn to proton pump inhibitors: epidemiology, etiology and management
| Autor: | Apostolos Mantides, Spiros N. Sgouros |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
medicine.medical_specialty
business.industry Muscle Relaxants Central Incidence Gastroenterology Functional heartburn Heartburn Proton Pump Inhibitors humanities Endoscopy Gastrointestinal Treatment Outcome Refractory Internal medicine Epidemiology medicine Etiology Gastroesophageal Reflux Humans medicine.symptom Enzyme Inhibitors business GABA Agonists |
| Zdroj: | Digestion. 73(4) |
| ISSN: | 0012-2823 |
| Popis: | Patients with refractory heartburn to proton pump inhibitors (PPIs) represent a distinctive group which is difficult to manage. In a systematic review of the relative literature we found that approximately 20% of patients with erosive esophagitis and 15–25% of patients with normal endoscopy and abnormal 24-hour esophageal pH monitoring continue to report heartburn despite treatment with standard dose PPIs. Furthermore, approximately 30–40% of patients with normal endoscopy and 24-hour pH studies and 15–20% of patients with Barrett’s esophagus have refractory heartburn to double dose PPIs. In such cases, compliance to therapy, duodeno-gastroesophageal reflux, gastro-esophageal motility disorders and eradication of Helicobacter pylori infection may contribute to symptoms. Based on the available evidence, we suggested an algorithm for the evaluation and management of these patients. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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