Which of the following is not true about medical management of uncomplicated GERD?: (A) Most effective management is PPI, (B) Advice head tilt to up 15 degrees helps in management, (C) Long term PPI increases malignancy risk, (D) Adequate dose of PPI for 8 weeks is the recommended treatment
Answer is C. Ans. (c) Long term PPI increases malignancy riskRef: Bailey and Love 27th Edition, Page 1079Medical treatment of GERD:Simple advices:* Weight loss* Stop smoking* Alcohol cessation* Tea and coffee avoidance* Avoid large meals* Modest head up tilt. (This effect is equal to H2 blockers)* Added Pillows have no effect.Medical Treatment:* PPI are most effective.* 8 weeks of PPI gives excellent response of 90%* Infact many patients will be long term PPI as they cannot modify their lifestyle* Risk of cancer stomach is unwarranted and no proven study on this aspect on long term PPI