Increasing the dose of current proton pump inhibitor (PPI) medication or switching to an alternative PPI are equally effective measures for reducing symptoms in people with persistent heartburn, say researchers.

Writing in the journal Clinical Gastroenterology and Hepatology, Dr Ronnie Fass, from the University of Arizona Health Sciences Center in Tucson, USA, and colleagues explain: "Common treatment practices in patients who continue to be symptomatic on PPI once-daily treatment include either increasing the dosage or the use of supplemental medication."

To compare the effectiveness of these treatment options, the researchers studied nearly 200 patients who were still experiencing heartburn symptoms after receiving therapy with the standard 30 mg once-daily dose of the PPI lansoprazole.

The participants received 8 weeks of treatment with either a once-daily 40 mg dose of the PPI esomeprazole or a twice-daily 30 mg dose of lansoprazole.

The team found that the participants who received esomeprazole experienced a similar number of heartburn-free days over the course of the study as those who received the increased dose of lansoprazole, at 54% and 57%, respectively.

Participants in both groups also experienced a similar level of improvement in the severity of their symptoms during the 8-week study period.

Dr Fass and team therefore conclude: "Switching patients with persistent heartburn on a standard-dose proton pump inhibitor to a different proton pump inhibitor was as effective as increasing the proton pump inhibitor dosage to twice daily for controlling heartburn symptoms."