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Systematic review: proton-pump inhibitor failure in gastro-oesophageal reflux disease--where next?Fass R; Shapiro M; Dekel R; Sewell JAliment Pharmacol Ther 2005[Jul]; 22 (2): 79-94Proton-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.|*Proton Pump Inhibitors[MESH]|Biological Availability[MESH]|Esophagitis/drug therapy[MESH]|Gastric Emptying/drug effects[MESH]|Gastroesophageal Reflux/*drug therapy[MESH]|Helicobacter Infections/complications[MESH]|Helicobacter pylori[MESH]|Humans[MESH]|Hypersensitivity/etiology[MESH]|Mental Disorders/complications[MESH]|Patient Compliance[MESH] |
