Omeprazole 10 Milligrams Once Daily, Omeprazole 20 Milligrams Once Daily, or Ranitidine 150 Milligrams Twice Daily, Evaluated as Initial Therapy for the Relief of Symptoms of Gastro-oesophageal Reflux Disease in General Practice

Venables, T. L.; Newland, R. D.; Patel, Ahmed; Hole, J.; Wilcock, Carol; Turbitt, M. L.

doi:10.3109/00365529709011211

Cited by 269 publications

(186 citation statements)

References 9 publications

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“…29 Several studies have found similar quality of life and symptom severity scores for patients with ERD and NERD. 4,24,30,31 Consistent with this, the symptom presentation for patients with NERD was not significantly different to that for patients with ERD in this study. The severity of reflux symptoms in patients with NERD indicates that these patients have significant illness and the same need for effective treatment as patients with ERD or BE.…”

Section: Discussionsupporting

confidence: 76%

“…It is well recognized that hiatal hernia is present in most patients with BE, and a lower frequency of hernia in patients with NERD has been reported. 4,24,25 In a large case control study, the presence and size of hernia was strongly associated with risk of developing high grade dysplasia or adenocarcinoma in patients with BE. 26 Hiatal hernia has also be identified as an important factor for the development of ERD in patients with NERD.…”

Section: Discussionmentioning

confidence: 99%

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Hiatal Hernia, Lower Esophageal Sphincter Incompetence, and Effectiveness of Nissen Fundoplication in the Spectrum of Gastroesophageal Reflux Disease

Lord

DeMeester

Peters

et al. 2009

Journal of Gastrointestinal Surgery

115

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Background and Aims Gastroesophageal reflux disease (GERD) is a spectrum of disease that includes nonerosive reflux disease (NERD), erosive reflux disease (ERD), and Barrett's esophagus (BE). Treatment outcomes for patients with different stages have differed in many studies. In particular, acid suppressant medication therapy is reported to be less effective for treating patients with NERD and Barrett's esophagus. The aims of this study were to investigate (1) the role of mechanical factors including hiatal hernia and lower esophageal sphincter (LES) competence in the spectrum of GERD and (2) outcomes of Nissen fundoplication. Methods From the records of patients who had undergone laparoscopic Nissen fundoplication after an abnormal pH study, we identified 50 symptomatic consecutive patients with each of the GERD stages: (1) NERD, (2) mild ERD, defined as esophagitis that was healed with acid suppression therapy, (3) severe ERD, defined as esophagitis that persisted despite medical therapy, and (4) BE. Exclusion criteria were normal distal esophageal acid exposure, esophageal pH monitoring performed elsewhere, antireflux surgery less than 1 year previously or previous fundoplication, and a named esophageal motility disorder or distal esophageal low amplitude hypomotility. Patients who could not be contacted for the study were also excluded. All patients completed a detailed preoperative questionnaire; underwent preoperative upper gastrointestinal endoscopy, stationary manometry, and distal esophageal pH monitoring; and were interviewed at least 1 year after operation. Results One hundred sixty patients meeting the entry criteria were studied. The mean follow-up period was 36.7 months. The only significant preoperative symptom difference was that patients with BE had more moderately severe or severe dysphagia compared to patients with NERD. Patients with severe ERD or BE had a significantly higher prevalence of hiatal hernia, lower LES pressures, and more esophageal acid exposure. Hiatal hernia and hypotensive LES were present in most patients with severe ERD or BE but in only a minority of patients with NERD or mild ERD. Surgical therapy resulted in similarly excellent symptom outcomes for patients in all GERD categories. Conclusions Compared to mild ERD and NERD, severe ERD and BE are associated with significantly greater loss of the mechanical antireflux barrier as reflected in the presence of hiatal hernia and LES measurements. Restoration of the antireflux barrier and hernia reduction by laparoscopic Nissen fundoplication provides similarly excellent symptom control in all patients.

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Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Hiatal Hernia, Lower Esophageal Sphincter Incompetence, and Effectiveness of Nissen Fundoplication in the Spectrum of Gastroesophageal Reflux Disease

Lord

DeMeester

Peters

et al. 2009

Journal of Gastrointestinal Surgery

115

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“…In patients with heartburn (NERD), PPI administration resolved symptoms only in 61% of the patients, which is approximately 20 to 30% lower effectiveness than that of patients with erosive esophagitis. 17,18 Fourty percent of the patients diagnosed with GERD fail to respond to once daily PPI regimen and majority of these patients belong to the NERD group and functional heartburn. In this situation, experts generally recommend to switch over to twice daily dosing regimen, however, before escalating the dose of PPI, it is important to analysis and consider other potential causes for nonresponsiveness like, poor compliance, improper dosing schedules, residual reflux reduced bioavailability.…”

Section: Acid Suppression Therapy For Gerdmentioning

confidence: 99%

What Should be the Approach in the Long-term Management of Patients with Gastroesophageal Reflux Disease?

Solih¹

2013

WJOLS

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“…(32) Gastroscopy has poor sensitivity (26,33) but good specifi city (90%-95%) (33) for the diagnosis of GERD in the presence of the endoscopic features of refl ux oesophagitis, peptic strictures, erosions, ulcers and Barrett's oesophagus. However, the majority of patients with refractory refl ux symptoms will have normal endoscopy.…”

Section: What Investigations Are Performed In a Specialist Setting? Gmentioning

confidence: 99%

Persistent gastro-oesophageal reflux symptoms despite proton pump inhibitor therapy

Ang

How

2016

smedj

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Omeprazole 10 Milligrams Once Daily, Omeprazole 20 Milligrams Once Daily, or Ranitidine 150 Milligrams Twice Daily, Evaluated as Initial Therapy for the Relief of Symptoms of Gastro-oesophageal Reflux Disease in General Practice

Abstract: Omeprazole, 20 mg, is the most effective initial therapy for relief of GORD symptoms.

Cited by 269 publications

References 9 publications

Hiatal Hernia, Lower Esophageal Sphincter Incompetence, and Effectiveness of Nissen Fundoplication in the Spectrum of Gastroesophageal Reflux Disease

Hiatal Hernia, Lower Esophageal Sphincter Incompetence, and Effectiveness of Nissen Fundoplication in the Spectrum of Gastroesophageal Reflux Disease

What Should be the Approach in the Long-term Management of Patients with Gastroesophageal Reflux Disease?

Persistent gastro-oesophageal reflux symptoms despite proton pump inhibitor therapy

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