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Aliment Pharmacol Ther. 2005 Jul 15;22(2):79-94.

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

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The Neuro-Enteric Clinical Research Group, Section of Gastroenterology, Southern Arizona VA Health Care System and University of Arizona, School of Medicine, Tucson, AZ, USA.


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.

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