Empirical trials in treatment of gastroesophageal reflux disease

The assortment of diagnostic tests that are currently available for detecti ng gastroesophageal reflux disease (GERD) are invasive, costly and not read ily available to community-based physicians, In contrast, a short course of high-dose proton pump inhibitor (PPI) as an empirical trial is an attracti ve alternative. This simple diagnostic test has been demonstrated to be acc urate and cost-effective in patients with symptoms suggestive of GERD and t hose with noncardiac chest pain. Early studies in patients with extraesopha geal manifestations of GERD have yielded promising results. Cost assessment of the PPI empirical trial revealed significant cost savings, mainly due t o a marked decrease in utilization of invasive diagnostic tests, Thus the P PI empirical trial should be considered as the initial diagnostic step in p atients with the disease spectrum of GERD, Copyright (C) 2000 S. Karger AG, Basel.