Clinical case study

PPIs: reviewing treatment for gastro-oesophageal reflux disease

How would you advise a patient with well-controlled gastro-oesophageal reflux disease (GORD) who would like to continue their proton pump inhibitor (PPI) therapy?

  • Cost: free



It is recommended that 1 CPD hour be recorded for the purposes of self-directed CPD.



Bill is an active 69-year-old man who would like to continue the pantoprazole that he has been taking for the past 6 months for GORD. What information would you like to know about Bill? How would you respond to his request?

Complete this online case study and receive instant feedback on your responses, compare your approach with your peers and read expert commentary provided by Prof Geoff Hebbard, the Director of Gastroenterology and Hepatology at The Royal Melbourne Hospital.


On completion of this activity you should be able to:

  • describe guideline recommendations for PPI use in GORD
  • list rare but serious adverse effects associated with PPI therapy
  • explain the advantages of and barriers to stepping down and stopping PPI therapy in patients with adequately controlled GORD symptoms
  • explain what is involved in stepping down and stopping PPI for GORD, including clear expectations and review times, and appropriate lifestyle changes
  • discuss strategies to manage potential rebound acid hypersecretion when stepping down or stopping PPI.