For pharmacological treatment of patients with gastroesophageal reflux disease (GERD), long-term acid suppression therapy (proton pump inhibitors or histamine2 receptor antagonists) should be titrated to the lowest effective dose needed to achieve therapeutic goals. The main identifiable risk associated with reducing or discontinuing acid suppression therapy is an increased symptom burden. It follows that the decision regarding the need for (and dosage of) maintenance therapy is driven by the impact of those residual symptoms on the patient’s quality of life rather than as a disease control measure.
The American Gastroenterological Association and the ABIM foundation joined forces to develop and distribute evidence based recommendations on when medical tests and procedures may be appropriate. Content was written to help physicians, patients and other health care stakeholders to think, to practice and partake in shared decision making to avoid unnecessary and at times harmful tests and procedures based on your condition or symptoms. Choosing Wisely recommendations should not be used to establish coverage decisions or exclusions.