Hospices Civils de Lyon, Université Claude Bernard Lyon I, Hôpital E Herriot, Services d’explorations fonctionnelles digestives, 5 place d’Arsonval, 69437 Lyon cedex 03
Proton pump inhibitors (PPI) are the cornerstone of gastro-esophageal reflux disease (GERD) treatment. Their indications are esophagitis healing, recurrence prevention and symptom relief. Treatment dose and duration are dependent on the indication. PPI are prescribed as first line treatment without previous examination in patients with typical GERD symptoms without warning signs. Complementary examinations are required in patients with warning signs or atypical symptoms to confirm diagnosis before PPI treatment. PPI therapeutic test is not recommended. In case of long-term treatment, the indication should be periodically re-evaluated and the minimal efficient dose should be prescribed. There is no argument to choose one PPI rather an other one. In well-selected patients, PPI dose can be increased.