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PPI Dosing in Non-Dysplastic Barrett Esophagus
Most patients respond to once-daily dosing of a proton pump inhibitor. If symptoms persist, increasing to twice daily or titrating dosage based on pH studies are both options.
In patients with non-dysplastic Barrett esophagus, what regimen of proton pump inhibitors (PPI) should be initially prescribed for management?
A. Once daily, 30-60 minutes before breakfast
B. Twice daily, 30-60 minutes before breakfast and before dinner
C. Given lack of dysplasia, no PPI is necessary
D. PPI use should be based on 24-hour pH testing
ANSWER: A
The role of PPIs in Barrett esophagus is to control symptoms. Whether acid suppressants have a chemotherapeutic role in preventing progression of dysplasia is controversial. Therefore, the regimen should be the lowest effective dose that controls symptoms. Most patients respond to once-daily dosing. If symptoms persist, increasing to twice daily or titrating dosage based on pH studies are both options.
Clinical Tips for Using Antibiotics and Corticosteroids in IBD
January 5th 2013The goals of therapy for patients with inflammatory bowel disorder include inducing and maintaining a steroid-free remission, preventing and treating the complications of the disease, minimizing treatment toxicity, achieving mucosal healing, and enhancing quality of life.
