PPI-resistant gastroesophageal reflux disease (GERD) is observed in up to 40% of patients with GERD. PPI (Proton Pump Inhibitors) resistance is generally considered as the persistence of symptoms such as heartburn and/or regurgitation in patients managed with a double dose of PPI for at least three months. This article discusses various management approaches for PPI resistant GERD. Whom to consider as PPI Resistant? The definition of "refractory" GERD is unsettled.
Some authorities consider refractory GERD as the failure to respond to a PPI given twice daily. Latest studies report that lack of satisfactory symptomatic response to PPI once a day is sufficient to consider patients as PPI failures. Approaches For PPI Resistant GERD 1. Proton Pump Inhibitors When a patient fails to respond to once-daily PPI, two types of modifications could be considered- Doubling the PPI dose The American…
