When proton-pump inhibitors fail, what is the best approach?

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When proton-pump inhibitors fail, what is the best approach?

Gastroenterology
Oesophagitis
Figure 1: Mild reflux oesophagitis, Figure 2: Severe reflux oesophagitis

Patients who get inadequate symptom improvement with a proton-pump inhibitor need careful consideration. To start our new column for 2018, Auckland gastroenterologist Alan Fraser looks at the investigation and management of refractory heartburn

The management of gastro-oesophageal reflux is now so much easier with proton-pump inhibitor treat­ment. If the patient returns and describes good sym