Long-term Therapy for Chronic Gastroesophageal Reflux

Gastroesophageal (GE) reflux and its many sequelae represent common and often relentless problems in management of patients. It has been estimated that approximately 10% of the population in the United States will have heartburn on a daily basis. 1 Many recent clinical trials have indicated that there are a variety of effective short-term therapies for the relief of reflux symptoms, including H 2 receptor blockers, metoclopramide, and bethanechol. 2-5 There is, however, little information available on effective long-term maintenance therapies of this common, persistent problem. In this issue of theArchives, Dr Lieberman 6 provides us with some interesting information in a group of 20 patients with chronic GE reflux disease followed up for up to 42 months. In all of these patients, their symptoms had initially been so persistent that even a standard dose of cimetidine (300 mg four times daily) had failed to improve their symptoms until this