| [ Summary ] |
Medical treatment strategies for GERD consist of two approaches. One is step-down therapy, which consists of using PPI as a drug of first choice, then stepping down to H2-RA if the symptoms resolve. Another is step-up therapy which uses H2-RA as a first drug of choice and stepping up to PPI if the symptoms are not resoived. Step-down therapy has the merits of faster symptom relief, faster healing and over all costs less. Faster healing might prevent further deterioration and complications from GERD. Because frequent endoscopy is not needed, step-down therapy is a more easily implemented strategy than step-up therapy. Moreover, even patients with the mild forms of GERD often require PPI, so that, step-down therapy, that is PPI-based medical treatment, is indicated irrespective of the severity of the GERD. |