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Evolution of therapy for reflux disease: JP Galmiche |
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In conclusion, with regard to the evolution of therapy in reflux disease, the control of acid secretion with PPI is at the moment the most effective, practical way to relieve symptoms, heal esophagitis, restore quality of life and keep patients in remission. New PPIs like rebeprazole have faster onset of action and improved pharmacological profile, for example, with less drug interference. There is a need for further evaluation of new long-term strategies such as the on-demand approach and combined therapy in severe or complicated reflux disease, for example the combination of a PPI and H2 receptor antagonist in Barrett's esophagus. We also need to work on the development of new drugs targeted on the control of pathophysiologic abnormalities such as transient lower esophageal sphincter relaxations or abnormal visceral perception. |
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