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Cited 12 time in webofscience Cited 16 time in scopus
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Management strategies for gastroesophageal reflux disease

Authors
Bak, YT
Issue Date
Sep-2004
Publisher
WILEY
Keywords
gastroesophageal reflux disease; management strategy; proton pump inhibitor; maintenance therapy; on-demand therapy
Citation
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, v.19, pp.S49 - S53
Indexed
SCIE
SCOPUS
Journal Title
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
Volume
19
Start Page
S49
End Page
S53
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/36472
DOI
10.1111/j.1440-1746.2004.03587.x
ISSN
0815-9319
Abstract
In the treatment of gastroesophageal reflux disease (GERD), the most effective treatment option is the use of proton pump inhibitor (PPI), which minimizes the effect of gastric acid on the distal esophagus. Both the step-up and step-down treatment strategies have advantages and disadvantages. Most physicians would like to choose the step-down therapy rather than the step-up therapy. The 'No-step' PPI therapy (i.e. continuous PPI therapy) is another relevant option. After an initial remission, long-term PPI therapy is an appropriate form of maintenance therapy in many patients. As a treatment plan for non-erosive reflux disease, a standard dose of PPI for 4-8 weeks followed by either the step-down strategy or the on-demand treatment strategy is acceptable. When treating erosive esophagitis, PPI is better than H-2 receptor blockers in healing mucosal breaks and relieving symptoms. Long-term maintenance PPI therapy is reported to be very effective in maintaining the remission of reflux esophagitis for up to 5 years. On-demand PPI is also another good option for a maintenance therapy in erosive esophagitis. In Barrett's esophagus, symptoms seem to be well-controlled with PPIs. Unfortunately, however, PPIs have no effect on the shortening of Barrett's esophagus or in preventing the progression to dysplasia and adenocarcinoma. In summary, after reviewing existing guidelines a rather simple guideline on the management of GERD is suggested - PPI should be given for 4-8 weeks followed by either on-demand or maintenance PPI therapy according to the clinical severity. (C) 2004 Blackwell Publishing Asia Pty Ltd.
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Bak, Young Tae
Guro Hospital (Department of Gastroenterology and Hepatology, Guro Hospital)
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