Review
Copyright ©The Author(s) 2005. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 28, 2005; 11(28): 4291-4299
Published online Jul 28, 2005. doi: 10.3748/wjg.v11.i28.4291
Treatment of uncomplicated reflux disease
Joachim Labenz, Peter Malfertheiner
Joachim Labenz, Department of Medicine, Jung-Stilling Hospital Siegen, Germany
Peter Malfertheiner, Department of Gastroenterology, Hepatology and Infectious Diseases, University of Magdeburg, Germany
Author contributions: All authors contributed equally to the work.
Correspondence to: Joachim Labenz, MD, Jung-Stilling Hospital, Wichern str. 40, D-57074 Siegen, Germany. j.labenz@t-online.de
Telephone: +49-271-333-4569 Fax: +49-271-333-4242
Received: December 24, 2004
Revised: January 6, 2005
Accepted: January 13, 2005
Published online: July 28, 2005
Abstract

Uncomplicated reflux disease comprises the non-erosive reflux disease (NERD) and erosive reflux disease (ERD). The objectives of treatment are the adequate control of symptoms with restoration of quality of life, healing of lesions and prevention of relapse. Treatment of NERD consists in the administration of proton pump inhibitors (PPI) for 2-4 wk, although patients with NERD show an overall poorer response to PPI treatment than patients with ERD owing to the fact that patients with NERD do not form a pathophysiologically homogenous group. For long-term management on-demand treatment with a PPI is probably the best option. In patients with ERD, therapy with a standard dose PPI for 4-8 wk is always recommended. Long-term treatment of ERD is applied either intermittently or as continuous maintenance treatment with an attempt to reduce the daily dosage of the PPI (step-down principle). In selected patients requiring long-term PPI treatment, antireflux surgery is an alternative option. In patients with troublesome reflux symptoms and without alarming features empirical PPI therapy is another option for initial management. Therapy should be withdrawn after initial success. In the case of relapse, the long-term care depends on a careful risk assessment and the response to PPI therapy.

Keywords: Erosive reflux disease; Non-erosive reflux disease; Proton pump inhibitor; Uninvestigated reflux disease