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Proton pump inhibitor-therapy refractory gastro-oesophageal reflux disease patients, who are they?
  1. Albert J Bredenoord1,
  2. John Dent2
  1. 1Dept of Gastroenterology, Sint Antonius Hospital, Nieuwegein, the Netherlands
  2. 2Royal Adelaide Hospital, Department of Gastroenterology, Adelaide, Australia
  1. Correspondence to:
    A J Bredenoord
    M.D., Dept of Gastroenterology, St. Antonius Hospital, PO Box 2500, 3430 EM Nieuwegein, the Netherlands;a.bredenoord{at}

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In a recent version of Gut, Mainie and colleagues report on patients with persistent symptoms despite acid suppressive therapy.1 This is often presented as a considerable problem and impedance seems useful in the evaluation of these patients. The importance of the phenomenon of proton pump inhibitor(PPI)-refractory symptoms is also stressed in studies in which the need for a new anti-reflux drug is propagated. However, we think some caution is appropriate when speaking of PPI-refractory gastro-oesophageal reflux disease …

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  • Competing interest: None.