Fass R, Shapiro M, Dekel R, Sewell J. Systematic review: proton-pump inhibitor failure in gastro-oesophageal reflux disease - where next? Aliment Pharmacol Ther. 2005;22(2):79–94.

Авторы: Fass R. / Shapiro M.S.  / Dekel R. / Sewell J.L.

Systematic review: proton-pump inhibitor failure in gastro-oesophageal reflux disease - where next?

Proton-pump inhibitor failure has become a common clinical dilemma in gastrointestinal clinics and has been increasingly encountered at the primary care level as well. Underlying mechanisms are diverse and may overlap. Most patients who have proton-pump inhibitor failure are likely to originate from the non-erosive reflux disease phenotype. Currently, available diagnostic modalities provide limited clues to the exact underlying cause. Treatment relies primarily on escalating dosing of proton-pump inhibitors. However, new insights into the pathophysiology of proton-pump inhibitor failure are likely to provide alternative therapeutic options.



Figure. A 24-h oesophageal pH tracing in a patient who continued to be symptomatic on proton-pump inhibitor twice a day. The pH test was unrevealing despite repeated reports of heartburn symptoms by the patient implying that symptoms were probably not caused by acid reflux.


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