W.B. Saunders for the American Gastroenterological Association
Clinical Gastroenterology and Hepatology vol:12 issue:10 pages:1647-55
Approximately 30% of patients with gastroesophageal reflux disease (GERD) have symptoms resistant to treatment with proton pump inhibitors (PPIs). Several mechanisms such as esophageal hypersensitivity, increased mucosal permeability and possibly the position of the gastric acid pocket might underlie a partial response to PPI. To what extent these mechanisms interact and contribute to PPI resistant symptoms has however not been investigated previously.