The aims of treatment of
gastroesophageal reflux disease (
GERD) are to cure mucosal breaks, control symptoms, and prevent complications (e.g.
stricture,
Barrett's esophagus, and esophageal
adenocarcinoma).
Proton pump inhibitors (PPIs) are known to be the best drugs to cure
esophagitis; however, a highrecurrence rate of about 80% was described after the completion of initial
therapy. Regretfully, not so many physicians perform maintenance
therapy in clinical practice.
Histamine H2 receptor antagonists have an insufficient effect in maintenance
therapy compared with PPIs; therefore, they could be prescribed for mild
reflux esophagitis. Several clinical trials have been conducted to investigate the efficacy of continuous PPI administration maintenance
therapy for
GERD. Among these trials, recent large-scale studies showed that
esomeprazole was equal to or superior to other kinds of PPIs. On the other hand, on-demand PPI studies have been conducted, mainly in patients with nonerosive reflux disease or uninvestigated
GERD;however, this strategy was less effective than continuous
therapy in many studies. Because on-demand
therapy is less expensive, it is worth confirming this strategy in further studies. Studies of maintenance
therapy with investigations conducted for as long a period as 5 years have described that PPI maintenance
therapy could be considered as effective, safe, and well tolerated.