ASGE Masterclass: Barrett’s Esophagus, GERD and Esophageal Adenocarcinoma (On Demand) | February 2022 OLMASFEB1222-Best and worst of PPIs

Best and worst of PPIs

Pdf Summary

This document discusses various aspects of proton pump inhibitors (PPIs) in the medical management of gastroesophageal reflux disease (GERD). PPIs are drugs that block the terminal step of acid secretion in the stomach and are effective in treating esophagitis. However, they may not be as effective for more severe cases of esophagitis. The time of day and dosing frequency also affect the efficacy of PPIs.<br /><br />The document also highlights the safety concerns associated with PPIs, including their interaction with other drugs like clopidogrel and their potential to increase the risk of cardiovascular events. However, the overall safety of PPIs is emphasized, and the alternatives, such as surgery, have their own limitations.<br /><br />The document mentions lifestyle modifications such as weight loss, dietary changes, and positional devices as adjunctive therapies for GERD. It also discusses other medications like baclofen and prokinetics that can be used in combination with PPIs.<br /><br />The importance of individualized treatment for GERD is highlighted, with recommendations for appropriate diagnostic procedures like endoscopy and reflux monitoring studies. It is also emphasized that long-term use of PPIs should only be considered in patients who are non-responsive to other therapies or have objective evidence of GERD.<br /><br />In conclusion, while PPIs are effective in managing GERD and improving quality of life for patients, their use should be tailored to the individual patient's needs and accompanied by appropriate diagnostic work-up and consideration of alternate therapies.

Keywords

proton pump inhibitors

GERD

acid secretion

esophagitis

safety concerns

drug interactions

lifestyle modifications

adjunctive therapies

individualized treatment

diagnostic procedures