HCPLive Network

Beyond PPIs: What is the Best Approach to Managing Refractory GERD?

 
The most pressing in managing gastroesophageal reflux disease (GERD) today is finding an effective approach to relieving refractory symptoms in patients on proton pump inhibitors, according to a specialist on the condition who spoke this week at a joint conference of the American Gastroenterological Association and the American Society for Gastrointestinal Endoscopy in Coronado, California.
 
A common condition, GERD is difficult to define but constitutes about 17 percent of all digestive disease diagnoses, said John Pandolfino, MD, professor of medicine, Gastroenterology and Hepatology, at the Feinberg School of Medicine at Northwestern University in Chicago. Proton pump inhibitors (PPI), which work by suppressing the production of stomach acids, are often prescribed to treat the condition. Although PPIs are considered to be effective treatment for GERD, 30-50% of patients complain that the medications do not adequately control their symptoms.
 
Almost everyone takes or has taken PPIs, said Pandolfino. However, some patients treated with PPI have refractory symptoms that cannot be controlled even with aggressive treatment. “The main clinical issue that we need to deal with in 2013 is refractory symptoms in patients on PPIs,” Pandolfino said.
 
The definition of refractory GERD is complex and confusing and patients who experience it are often referred to as PPI non-responders because they don’t improve with PPI treatment, said Pandolfino. But many patients who don’t respond to PPI treatment actually don’t have reflux; they may have other conditions, such as functional heartburn, that mimic but are not GERD, he said.


Further Reading
For patients with hypertension, finding the right course of treatment can be critically important especially when other health factors are taken into consideration.
One accountable care organization saved $8.5 million and received a check from Medicare for $4.2 million after 17 months. Suddenly, they had physicians clamoring to join.
Although previous research has found probiotics can prevent antibiotic-associated diarrhea (AAD) and Clostridium difficile diarrhea (CDD), a study from researchers in the United Kingdom and Germany reported contradicting results.
Even though the active ingredient in marijuana can be associated with memory impairment, it may slow or halt Alzheimer’s disease.
Simply shifting from manual to electronic transactions for just 6 processes could save physicians and other healthcare providers billions of dollars.
Peripheral neuropathy was found in a third of HIV patients in a recent study of 58 men with a median age of 36 years.
Men who are socially well-integrated show more than a 2-fold reduced risk of suicide, according to a longitudinal study published in the Annals of Internal Medicine.
More Reading
For patients with hypertension, finding the right course of treatment can be critically important especially when other health factors are taken into consideration.