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Review
. 2016 Feb;39(1):6-10.
doi: 10.18773/austprescr.2016.003. Epub 2016 Feb 1.

The management of gastro-oesophageal reflux disease

Charlotte Keung  1 , Geoffrey Hebbard  1
Affiliations
Review

The management of gastro-oesophageal reflux disease

Charlotte Keung et al. Aust Prescr. 2016 Feb.

Abstract

If there are no features of serious disease, suspected gastro-oesophageal reflux disease can be initially managed with a trial of a proton pump inhibitor for 4-8 weeks. This should be taken 30-60 minutes before food for optimal effect. Once symptoms are controlled, attempt to withdraw acid suppression therapy. If symptoms recur, use the minimum dose that controls symptoms. Patients who have severe erosive oesophagitis, scleroderma oesophagus or Barrett's oesophagus require long-term treatment with a proton pump inhibitor. Lifestyle modification strategies can help gastro-oesophageal reflux disease. Weight loss has the strongest evidence for efficacy. Further investigation and a specialist referral are required if there is no response to proton pump inhibitor therapy. Atypical symptoms or signs of serious disease also need investigation.

Keywords: endoscopy; gastro-oesophageal reflux disease; histamine H2 antagonists; proton pump inhibitors.

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Conflict of interest statement

Conflict of Interest: Geoffrey Hebbard has received research support, travel assistance or eaten food provided by most of the Australian manufacturers and/or distributors of acid suppressing medication (from cimetidine onwards). He has recently been paid to appear in a video presentation by NPS MedicineWise, and is involved in the (unpaid) writing of guidelines for the use of acid suppression in Therapeutic Guidelines.

Charlotte Keung has eaten food provided by the manufacturers and distributors of PPIs.

Figures

Fig
Fig
Approach to management of gastro-oesophageal reflux disease
See this image and copyright information in PMC

References

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Further reading

    1. NPS MedicineWise. Proton pump inhibitors – too much of a good thing? MedicineWise News 2015 Mar 16. www.nps.org.au/publications/ health-professional/nps-news/2015/proton-pu... [cited 2016 Jan 4]
    1. NPS MedicineWise. Pharmacological management of gastro-oesophageal reflux disease. 2015 Mar 30. www.nps.org.au/conditions/digestive-system-problems/indigestion-reflux-a... [cited 2016 Jan 4]