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Patients with NERD may exhibit similar symptom severity to those with erosive GERD but as many as half of them may have a normal esophageal pH testing demonstrating pH values within the normal range of healthy subjects ().

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H2-receptor antagonists, prostaglandin or sucralfate within 14 days prior to enrollment or with a proton pump inhibitor, prokinetic agent or bismuth subsalicylate within 30 days prior to enrollment; concurrent significant illnesses including cancer and renal or hepatic disease; any history of clinically significant alcohol abuse or other psychiatric illnesses; any predisposing condition that might interfere with the absorption, distribution, metabolism or excretion of any study drug; any history of multiple medication allergies or history of severe drug-associated adverse event.

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The other is an ongoing 10-year study, in which maintenance therapy with pantoprazole 40 mg to 160 mg daily was well tolerated in patients with healed peptic ulcers or erosive esophagitis.

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Suppression of gastric acid by PPIs interrupts negative-feedback mechanisms by which gastrin secretion is regulated, since high levels of gastric acid normally inhibit gastrin secretion, prolonged PPI treatment leads to hypergastrinemia.

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