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A Clinical Indication for Rational Prescribing

James C. Gregor, MD

JAMA. 2004;292:2012-2013.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Disorders of the upper gastrointestinal (GI) tract, both symptomatic and asymptomatic, have been ubiquitous in humans throughout the history of medicine. Although important advances, such as the discovery of Helicobacter pylori, have offered curative options for many patients, lifestyle habits and the increasing use of other medication classes, including nonsteroidal anti-inflammatory drugs (NSAIDs) and anticoagulants in western countries, ensure that disorders such as gastroesophageal reflux and NSAID gastropathy will remain prevalent for decades to come.

The development over the last 40 years of potent acid-suppressing agents, first H₂ receptor antagonists (H₂RAs) and subsequently the more potent proton pump inhibitors (PPIs), have led to major improvements in both disease management and diagnosis. Because of their efficacy and impressive safety profile that has far exceeded original expectations, acid-suppressing drugs have consistently been among the most widely prescribed medications worldwide, with almost $13 billion in sales in . . . [Full Text of this Article]

Author Affiliation: Departments of Medicine and Epidemiology & Biostatistics, University of Western Ontario, London, Ontario.

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