Previously, histamine-2 receptor antagonist therapy was recommended as the initial treatment for esophagitis associated with GERD; however, subsequent studies of cost-effectiveness and symptom relief suggested that PPIs are superior.
Patients with uncomplicated GERD who respond to short-term PPIs should subsequently attempt to stop or reduce them. Patients who cannot reduce PPIs should consider ambulatory esophageal pH/impedance monitoring before committing to lifelong PPI therapy, to help distinguish GERD from a functional syndrome.
Patients at high risk for ulcer-related bleeding from nonsteroidal anti-inflammatory drugs (NSAIDs) should take a PPI, if they continue to take NSAIDs.
The dose of long-term PPIs should be periodically reevaluated so that the lowest effective PPI dose can be prescribed to manage the condition.
Long-term PPI users should not routinely use probiotics to prevent infection.
Long-term PPI users should not routinely raise their intake of calcium, vitamin B12, or magnesium beyond the recommended dietary allowance.
Long-term PPI users should not routinely screen or monitor bone mineral density, serum creatinine levels, magnesium levels, or vitamin B12 levels.
Specific PPI formulations should not be selected on the basis of potential risks.
Medscape © 2020 WebMD, LLC
Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: B.S. Anand. Fast Five Quiz: Esophagitis - Medscape - Jul 14, 2020.