Evolution of therapy for reflux disease:
where are we? Where are we going?
JP Galmiche
CHU, Nantes, France
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Evolution of therapy for reflux disease: JP Galmiche |
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There are, however, certain shortcomings and limitations of currently available first generation PPIs. These were nicely summarized by Professor Tytgat in a recent review. These include a slow speed of onset of acid inhibition, prolonged acid suppression once steady stage is reached, difficulty in reaching complete acid suppression, nocturnal acid breakthrough, variable in vivo bioavailability, possible interference with cytochrome P450 metabolism, especially relevant in the elderly, and acid rebound upon stopping the PPI which may lead to PPI dependence. |
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