Favorable response to proton pump inhibitors doesn’t necessarily diagnose GERD
The Journal of Family Practice. 2004 September;53(9):682-690
September 1, 2004|The Journal of Family Practice
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- CLINICAL QUESTION: If patients respond to treatment with proton pump inhibitors, does that mean that they have gastroesophageal reflux disease?
- STUDY DESIGN: Meta-analysis (randomized controlled trials)
- SETTING: Various (meta-analysis)
- SYNOPSIS: Several guidelines on the treatment of gastroesophageal reflux disease (GERD) suggest lifestyle changes and treatment with acid-suppressive therapy as the first-line approach. A favorable response to therapy with a proton pump inhibitor (PPI) often is used as confirmation of the diagnosis (the PPI test).
BOTTOM LINE
Response to treatment with a proton pump inhibitor does not identify patients as having gastroesophageal reflux disease. As a result, an initial response should not consign the patient to long-term therapy. These results agree with other research showing that patients can use short-term treatment (2 weeks), stop treatment, and then begin treatment again if symptoms recur, which won’t happen in approximately half of them (BMJ 1999; 318:502–507). (LOE=1a)
