First line therapy for gastroesophageal reflux disease (GERD) has been considered to be an administration of a proton pump inhibitor (PPI) based on the clinical evidence developed in western ...countries. Gastric acid secretion of the Japanese is lower than those of western persons. Therefore, Japanese physicians hesitate to administer PPI in patients with GERD. Several high quality clinical studies have recently been done in Japan and they clearly indicate that PPI is the most powerful and appropriate first line therapeutic drug for patients with reflux esophagitis as well as non-erosive reflux disease. PPIs most effectively heal esophageal mucosal breaks, alleviate reflux symptoms, and improve health-related quality of life of patients with GERD.
Gastroesophageal reflux disease (GERD) is defined on the clinical symptoms and pathophysiology of the disease. Therefore, endoscopic study has a subsidiary role in the diagnosis of GERD. The ...information obtained by endoscopic study, however, is pivotal for finding other disease than GERD that may cause reflux-like symptoms, for understanding pathophysiology of reflux disease by grading esophageal mucosal lesions, and for identifying Barrett's esophagus and assessing the therapeutic effect on it after the endoscopic or medical treatment. Therefore, the purpose of the endscopic study should be well recognized by all the endoscopists before doing study on each patient with different problems. Gastroenterological Endoscopy
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