Gastroesophageal reflux disease (
GERD) is associated with several symptoms, such as
heartburn,
belching, and regurgitation, which arise from esophageal exposure to gastric acid. Symptoms may occur in the absence of endoscopically observed esophageal mucosal damage and
inflammation. These patients represent the majority of those who present with
GERD symptoms. Although
acid suppression
therapy is a logical approach to relieving
GERD symptoms, it has been thought to relieve symptoms less reliably in patients with endoscopically negative, or symptomatic
GERD than in those with erosive
GERD. Two multicenter, randomized, double-blind, placebo-controlled clinical trials were conducted in the United States to evaluate the efficacy of
rabeprazole sodium 10 mg and 20 mg compared with placebo for the relief of
heartburn and other symptoms associated with symptomatic
GERD. Results from these studies indicated that
rabeprazole 10 or 20 mg once daily relieved
heartburn within the first 1 or 2 days of treatment and also had significant positive effects on other
GERD symptoms, including regurgitation,
belching, bloating, satiety, and
nausea. Overall, these results suggest that
rabeprazole may hold a significant therapeutic advantage in the treatment of
heartburn and other symptoms associated with endoscopically negative
GERD, particularly in the majority of patients who often are treated empirically without, or before, endoscopic evaluation.