Curbside Consultation in GERD: 49 Clinical Questions

Philip O. Katz, MD

Question 20: A Patient With Long-Standing Gerd Is Asymptomatic On A Once-Daily Ppi. He Wants To Know If He Needs To Take His Medication “For The Rest Of His Life.” Address The Long-Term Maintenance Therapy For Gerd. (continued)

You are faced with a patient who has had an excellent response to once-a-day proton pump inhibitor with complete relief of reflux symptoms. In answering the question, “Does he need to take medication for the rest of his life?” it is important to put into perspective the natural history of gastroesophageal reflux disease, both from the standpoint of symptomatic recurrence, recurrence of erosive disease, and the potential for complications long term (Figure 20-1). It is very clear that this person, regardless of his age, gender, or ethnic background, will have some recurrence of…