The rising trend of on-demand and intermittent proton pump inhibitor therapy in gastroesophageal reflux disease: What is the evidence?

Gastroesophageal reflux disease is a chronic and relapsing disease. Its symptoms do not correlate well with the degree of reflux events or injury that pose a challenge in its management. Thus far, treatment modalities include lifestyle and dietary modifications, antacids and anti-secretory medications, and anti-reflux surgery. With an erratic symptom atology, high cost of treatment, and fear of complications and side effects, the dilemma arises as to when treatment is stopped. Diverse therapeutic strategies continue to advance to address such concerns. The rising trend of on-demand and intermittent proton pump inhibitor therapy has raised various issues regarding efficacy.