The use of proton pump inhibitors is increasing thanks to both novel therapeutic protocols for existing indications such as peptic ulcer diseases and to expanded indications, such as non-cardiac chest pain and asthma. Gastroenterologists who treat reflux disease and peptic ulcer disease as well as ENT [Editor's note: ears, nose, throat] disorders and primary care physicians who treat patients presenting extraesophageal manifestations of reflux disease must be updated on how these medications fit into the treatment strategies currently employed.

Overview

This program discusses the diagnosis and the management of NET and highlights newer medical therapies that are being added to the armamentarium. Major symptomatology, laboratory tests and biomarkers, and imaging options are reviewed, including the use of radiolabeled congeners of natural ligands. The surgical options are overviewed and the two major biotherapies are featured. The impact of hormonal symptoms' control on the quality of life of patients suffering from indolent tumors is analyzed.

Audience

This program has been specifically developed to update and educate gastroenterologists and primary care physicians who provide care for people with all presentations of reflux or peptic ulcer disease.

Learning objectives

 Outline the medications currently used in the treatment of peptic ulcer diseases and reflux disease

 Identify the mechanism of action for each class of agents used in the treatment of peptic ulcer diseases and reflux disease

 Characterize the pharmacological profile of proton pump inhibitors

 Outline the state-of-the-art of medical options for the treatment of gastroesophageal reflux disease (GERD), both erosive and non-erosive

 Discuss the state-of-the-art pharmacological approach to peptic ulcer disease whether of bacterial origin (H. pylori) or induced by NSAID (non-steroidal anti-inflammatory drug) usage

 Discuss the medical options for the treatment of different extraesophageal manifestations of reflux diseases

Summary

This program provides an overview on PPIs and their therapeutic use in peptic ulcer disease, gastroesophageal reflux disease (GERD) and its extraesophageal manifestations. The increasing role of PPI therapy for non-GI-related conditions is highlighted.

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Faculty

Alan Cutler MD
(Program Chair)
Assistant Professor of Medicine
Wayne State University School of Medicine
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John Horn PharmD
Professor of Pharmacology
University of Washington
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Malcolm Robinson
Clinical Professor of Medicine
University of Oklahoma
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Faculty disclosure information

CME credit
The American Gastroenterological Association offers users in the United States continuing medical education (CME) credit for participating in this learning module.
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Accreditation statement

Key clinical issue: What are the pharmacological implications of the different activation rates Of proton pump inhibitors?
 

Key Clinical Issue: What are the best treatment options for gastroesophageal reflux disease (GERD)?

Faculty disclosure information

In accordance with the Accreditation Council for Continuing Medical Education Standards for Commercial Support, faculty members for this activity were each asked to complete financial disclosure forms. Disclosures are provided below.

Alan Cutler MD
Nothing to disclose

Malcolm Robinson MD
Consultant: Salix, Wrigley, Reliant, Eisai, Janssen Pharmaceutica Inc., Pfizer; (prior close relationships and consultancies with TAP, AstraZeneca, Wyeth, Johnson and Johnson-Merck)
Grant/Research Support: Oklahoma Foundation for Digestive Research support includes: Wyeth, GlaxoSmithKline, TAP, Janssen Pharmaceutica Inc., Eisai, Wrigley, Pfizer, AstraZeneca, Reliant, Solvay, Novartis
Speakers' Bureau: Active speaker for TAP, Janssen, and Novartis Pharmaceuticals Corporation

John Horn MD
Speakers' Bureau: Janssen and TAP

Accreditation statement

The views expressed herein, while consistent with current medical literature, are solely those of the faculty.

The American Gastroenterological Association (AGA) is accredited by the Accreditation Council for Continuing Medical Education to sponsor continuing medical education for physicians.

The AGA designates this educational activity for a maximum of 1.5 credit hours in Category 1 credit toward the AMA Physician's Recognition Award. Each physician should claim only those hours of credit that he/she actually spent in the educational activity.

All presenters participating in continuing medical education programs sponsored by the AGA are expected to disclose to the program audience any real or apparent conflict(s) of interest related to the content of their presentation. In addition, presenters and moderators are asked to make a reasonable effort to identify for the program audience any discussion of off-label or investigative use or application of a product or device that may occur during the educational presentation.

Funding for the development and production of the Current and Emerging Uses of Proton Pump Inhibitors multimedia module was provided through an educational grant from Eisai Inc. and Janssen Pharmaceutica Inc.