Should PPI Therapy Be Interrupted for pH/Impedance Monitoring?

Some researchers say yes, but our expert says no.

Proton-pump inhibitors (PPIs) are the dominant strategy for treating moderate-to-severe gastroesophageal reflux disease. Although these agents are extremely effective, they fail in a subset of patients with suspected GERD. Defining the optimal diagnostic and therapeutic strategies for these patients has been problematic. Particularly vexing is the question of whether to perform 24-hour pH/impedance monitoring while patients are on or off PPI therapy.

To explore this issue, investigators conducted a prospective, randomized, crossover trial among 30 patients who had symptoms of heartburn, chest pain, or regurgitation despite twice-daily PPI therapy. Each patient underwent monitoring both on and off therapy. Reflux episodes were identified as a…

Reviewing Author

David A. Johnson, MD

Disclosures

Consultant/Advisory boardMedscape/WebMD; Pfizer; CRH Medical Corporation; Aries

EquityCRH Medical Corporation

Editorial boardsMedscape Gastroenterology

Leadership positions in professional societiesAmerican College of Gastroenterology Research Institute Board of Directors