Reviews for Primary Care - Fall 2007 - (Page 62) GERD Symptoms on Antisecretory Therapy continued frequency or volume of reflux or hypersensitivity to physiologic amounts. This area is clearly in evolution; and (3) the diagnosis of GERD is incorrect. Either the patient has residual symptoms not related to acid or non–acid reflux or the patient did not have GERD in the first place. The latter is seen with increasing frequency as higher doses of antisecretory therapy are given empirically. Whereas this practice is in many cases reasonable, it may complicate evaluation later. These patients require a full evaluation including careful review of the history, compliance with therapy, upper gastrointestinal endoscopy, and prolonged reflux monitoring, often both on and off antisecretory therapy. References 1. Richter JE, Kahrilas PJ, Johanson J, et al. Efficacy and safety of esomeprazole compared with omeprazole in GERD patients with erosive esophagitis: a randomized controlled trial. Am J Gastroenterol. 2001;96:656-665. Kahrilas PJ, Falk GW, Johnson DA, et al. Esomeprazole improves healing and symptom resolution as compared with omeprazole in reflux oesophagitis patients: a randomized controlled trial. Aliment Pharmacol Ther. 2000;14:12491258. Castell DO, Kahrilas PJ, Richter JE, et al. Esomeprazole (40 mg) compared with lansoprazole (30 mg) in the treatment of erosive esophagitis. Am J Gastroenterol. 2002;97:575-583. Labenz J, Armstrong D, Lauritsen K, et al. A randomized comparative study of esomeprazole 40 mg versus pantoprazole 40 mg for healing erosive esophagitis: The EXPO study. Aliment Pharmacol Ther. 2005;21:739-746. Fennerty MB, Johanson JF, Hwang C, Sostek M. Efficacy of esomeprazole 40 mg vs. lansoprazole 30 mg for healing moderate to severe erosive esophagitis. Aliment Pharmacol Ther. 2005; 21(4):455-463. Chiba N, DeGara CJ, Wilkinson JM, Hunt RH. Speed of healing and symptom relief in grade II to IV gastroesophageal reflux disease: a meta analysis. Gastroenterology 1997;112:1798-1810. Castell DO, Richter JE, Robinson M, et al. Efficacy and safety of lansoprazole in the treatment of erosive reflux esophagitis. Am J Gastroenterol. 1996;91:1749-1757. Mossner J, Holscher AH, Herz R, Schneiders A. A double-blind study of pantoprazole and omeprazole in the treatment of erosive or ulcerative gastro-oeosophageal reflux disease. Aliment Pharmacol Ther. 1999;13:49-57. 2. 3. 4. 5. 6. 7. 8. Dekkers CPM, Beker JA, Thjodleifsson B, et al. Double-blind, placebo controlled comparison of rabeprazole 20 mg vs omeprazole 20 mg in the treatment of erosive or ulcerative gastrooesophageal reflux disease. Aliment Pharmacol Ther. 1999;13:49-57. 10. Lind T, Havelund T, Carlsson O, et al. Heartburn without oesophagitis: efficacy of omeprazole therapy and features determining therapeutic response. Scand J Gastroenterol. 1997;32:974-979. 11. Bate CM, Griffin SM, Keeling PWN, et al. Reflux symptom relief with omeprazole in patients without unequivocal oesophagitis. Aliment Pharmacol Ther. 1996;10:547-555. 12. Katz PO, Castell DO, Chen Y, et al. Intragastric acid suppression and pharmacokinetics of twice daily esomeprazole: a randomized, three-way crossover study. Aliment Pharmacol Ther. 2004; 20:399-406. 13. Hatlebakk JG, Katz PO, Kuo B, Castell DO. Nocturnal gastric acidity and acid breakthrough on different regimens of omeprazole 40 mg daily. Aliment Pharmacol Ther. 1998;12:1235-1240. 14. Castell D, Bagin R, Goldlust B, et al. Comparison of the effects of immediate-release omeprazole powder for oral suspension and pantoprazole delayed-release tablets on nocturnal acid breakthrough in patients with symptomatic gastroesophageal reflux disease. Aliment Pharmacol Ther. 2005;21:1467-1474. 15. Katz P, Ballard ED, Koch FK, et al. Nocturnal gastric acidity after bedtime dosing of proton pump inhibitors in patients with nighttime GERD symptoms [abstract S1200]. Gastroenterology. 2006;130:A-175. 16. Katz PO, Hatlebakk JG, Castell DO. Gastric acidity and acid breakthrough with twice-daily omeprazole or lansoprazole. Aliment Pharmacol Ther. 2000;14:709-714. 17. Miner P Jr., Katz PO, Chen Y, Sostek M. Gastric acid control with esomeprazole, lansoprazole, omeprazole, pantoprazole, and rabeprazole: a five-way crossover study. Am J Gastroenterol. 2003;98:2616-2620. 18. Katz P, Miner P, Chen Y, et al. Effects of 5 marketed proton pump inhibitors on acid suppression relative to a range of pH thresholds. Am J Gastroenterol. 2004;99:S34. 19. Peghini PL, Katz PO, Castell DO. Ranitidine controls nocturnal gastric acid breakthrough on omeprazole: a controlled study in normal subjects. Gastroenterology. 1998;115:13351339. 20. Tutuian R, Katz PO, Ahmed F, et al. Over-thecounter H2 receptor antagonists do not compromise intragastric pH control with proton pump inhibitors. Aliment Pharmacol Ther. 2002; 16:473-477. 21. Khoury R, Katz PO, Hammod R, Castell DO. Bedtime ranitidine does not eliminate the need for a second daily dose of omeprazole to suppress nocturnal gastric pH. Aliment Pharmacol Ther. 1999;13:675-678. 22. Guda N, Mueller R, Vakil N. The effect of over the counter ranitidine (75 mg) on nighttime heartburn in patients with erosive esophagitis on daily proton pump inhibitor maintenance therapy. Gastroenterology. 2003;124:A539. 9. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. Winters C, Spurling TJ, Chobanian SJ, et al. Barrett’s esophagus: a prevalent, occult complication of gastroesophageal reflux disease. Gastroenterology. 1987;92:118-124. Lieberman DA, Oehlke M, Helfand M, and the GORGE Consortium. Risk factors for Barrett’s esophagus in community-based practice. Am J Gastroenterol. 1997;92:1293-1297. Collen MJ, Abdulian JD, Chen YK. Gastroesophageal disease in the elderly: more severe disease that requires aggressive therapy. Am J Gastroenterol. 1995;90:1053-1057. Johnson DA, Fennerty MB. Heartburn severity underestimates erosive esophagitis severity in elderly patients with gastroesophageal reflux disease. Gastroenterology. 2004;126(3):660-664. Srinivasan R, Tutuian R, Schoenfeld, P, et al. Profile of GERD in the adult population of a northeast urban community. J Clin Gastroenterol. 2004;38:651-657. Peghini PL, Katz PO, Bracy NA, Castell DO. Nocturnal recovery of gastric acid secretion with twice-daily dosing of proton pump inhibitors. Am J Gastroenterol. 1998;93:763-767. Katz PO, Anderson C, Khoury R, Castell DO. Gastro-oesophageal reflux associated with nocturnal gastric acid breakthrough on proton pump inhibitors. Aliment Pharmacol Ther. 1998;12: 1231-1234. Charbel S, Khandwala F, Vaezi MF. The role of esophageal pH monitoring in symptomatic patients on PPI therapy. Am J Gastroenterol. 2005;100:283-289. Katzka DA, Paoletti V, Leite L, Castell DO. Prolonged ambulatory pH monitoring in patients with persistent gastroesophageal reflux symptoms: testing while on therapy identifies the need for more aggressive anti-reflux therapy. Am J Gastroenterol. 1996;91:2110-2113. Katz P, Gideon RM, Tutuian R. Reflux symptoms on twice daily (bid) proton pump inhibitors (PPI) associated with non-acid reflux: a manifestation of hypersensitive esophagus? Gastroenterology. 2005;128:A130 [Abstract 825]. Mainie I, Tutuian R, Agrawal A, et al. Symptom type on PPI therapy does not predict reflux identified by multichannel intraluminal impedance-pH. Gastroenterology. 2005;128:A394 [M1796]. Katzka DA, Castell DO. Successful elimination of reflux symptoms does not ensure adequate control of acid reflux in Barrett’s esophagus. Am J Gastroenterol. 1994;89:989-991. Fass R, Sampliner RE, Malagon IB, et al. Failure of oesophageal acid control in candidates for Barrett’s oesophagus reversal or a very high dose PPI. Aliment Pharmacol Ther. 2000;14:597-602. Ouatu-Lascar R, Triadafilopoulos G. Complete elimination of reflux symptoms does not guarantee normalization of intraesophageal acid reflux in patients with Barrett’s esophagus. Am J Gastroenterol. 1998;93:711-716. El-Serag H, Aguirre T, David S, et al. Proton pump inhibitors are associated with reduced incidence of dysplasia in Barrett’s esophagus. Am J Gastroenterol. 2004;99:1877-1883. Marks RD, Richter JE, Rizzo J, et al. Omeprazole versus H2-receptor antagonists in treating VOL. 1 NO. 1 2007 REVIEWS FOR PRIMARY CARE
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