- A person is likely to have GORD if they have reflux symptoms that are frequent (two or more episodes per week) or severe enough to significantly impair their quality of life.
- Diet and lifestyle modifications may be sufficient for people with mild intermittent reflux symptoms, but those with GORD will also require treatment with a PPI.
- For patients with, or suspected of having, GORD, start a standard-dose PPI for 4 to 8 weeks with a planned review.
- Regularly review patients who are taking PPIs for GORD, with the aim of reducing or stopping PPI treatment when symptoms are well controlled.
Practice review – GORD: stepping down PPIs
Australian GPs recently received a Practice Review on their prescribing of PPIs in practice.
- Reflect on your data in relation to your patients and their indications for PPIs
- Find more information to help you interpret and understand your data
- Access a sample report
Medicinewise News: Stepping the appropriate path with GORD medicines
PPIs are among the most commonly prescribed medicines in Australia. Guideline recommendations for GORD encourage starting daily PPI treatment for 4 to 8 weeks, and reducing or stopping treatment when GORD symptoms are well controlled.
News feature: PPI use and risk of death – cause for concern?
A 2017 publication found an increased risk of death with PPI use. Although the study results were statistically significant, how the findings relate to clinical practice is worthy of discussion.
Australian Prescriber: The management of gastro-oesophageal reflux disease
Charlotte Keung and Geoffrey Hebbard
Aust Prescr 2016;39:36–9
GORD is one of the most common gastrointestinal conditions and may result in significant morbidity. In patients with typical symptoms, treatment can be based on symptoms alone with a trial of PPI therapy.
- Educational visit: Starting, stepping down and stopping medicines (bookings closed)
- Clinical e-Audit: PPIs in GORD: a stepped approach
- Case study: PPIs: Reviewing treatment for gastro-oesophageal reflux disease