Systematic review: proton‐pump inhibitor failure in gastro‐oesophageal reflux disease – where next?

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Abstract
Proton‐pump inhibitor failure has become a common clinical dilemma in gastrointestinal clinics and has been increasingly encountered at the primary care level as well. Underlying mechanisms are diverse and may overlap. Most patients who have proton‐pump inhibitor failure are likely to originate from the non‐erosive reflux disease phenotype. Currently, available diagnostic modalities provide limited clues to the exact underlying cause. Treatment relies primarily on escalating dosing of proton‐pump inhibitors. However, new insights into the pathophysiology of proton‐pump inhibitor failure are likely to provide alternative therapeutic options.