What pharmacological treatment should be used in patients with symptoms of gastroesophageal reflux disease?
Janusz Jankowski, MD, PhD: There are 4 different choices available to most people. It starts off with prn (as-needed)—take it as you have symptoms—proton pump inhibitors (PPIs). Low-dose PPIs once a day, low-dose PPIs twice a day, and high-dose PPIs twice a day.
Most patients who have been weaned off PPIs will be on a prn basis. Most other of the new patients will be on either low-dose PPIs once a day or low-dose twice a day. We reserve the high-dose PPIs for twice daily treatment for people with severe symptoms or severe esophagitis.