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Principal mechanisms and factors involved in proton pump inhibitor resistance
| Adherence to PPI therapy |
| Compliance |
| Dosing, time |
| Reflux pattern |
| Weakly acidic reflux |
| Proximal reflux |
| Mixed reflux |
| Residual acid refluxes |
| Esophageal hypersensitivity |
| Other mechanisms |
| Reduced PPI bioavailability |
| Increased PPI metabolism |
| Mutations cyt. p450 |
PPI: Proton pump inhibitor.
