Rapid Rx Quiz: Proton Pump Inhibitors (PPIs)

Mary L. Windle, PharmD


February 22, 2022

The recent ACG guidelines recommend against routine addition of medical therapies in PPI nonresponders. However, they suggest a trial of switching PPIs is reasonable for patients who have not responded to an initial PPI. For patients who have not responded to one PPI, more than one switch to another PPI cannot be supported.

PPI nonresponders may not be adherent to their medication or may be taking PPIs at bedtime rather than before meals; they may also have a dose that is too low. However, comorbidities are also possible, such as gastroparesis, eosinophilic esophagitis, esophageal motility disorders, or rumination syndrome. These may be mistaken for PPI nonresponse or functional heartburn, which is treated without PPIs.

Learn more about the treatment of GERD.


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