Implications of Long-term Proton Pump Inhibitor Use: Promoting Step-Down Therapy for Management of Gastro-esophageal Reflux Disease in the Outpatient Setting

Per the International Montreal Consensus, gastro-esophageal reflux disease (GERD) is defined as a condition which develops when the reflux of stomach contents causes troublesome symptoms or complications . GERD is the most common disease of the gastrointestinal tract with an estimated prevalence affecting 20% of the Western population. According to the National Ambulatory Medical Care Survey, 38.53 million annual outpatient visits are related to GERD. The ABIM Foundation\u27s Choosing Wisely initiative in collaboration with the American Gastroenterological Association draws attention to the evidence based recommendation: For pharmacological treatment of patients with gastro-esophageal reflux disease (GERD), long-term acid suppression therapy (proton pump inhibitors or histamine2 receptor antagonists) should be titrated to the lowest effective dose needed to achieve therapeutic goals.https://scholarworks.uvm.edu/fmclerk/1059/thumbnail.jp