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A short course of PPI is a pragmatic approach to address reflux\u2010like symptoms, but equally important is counselling about the gut\u2010brain axis and provision of symptom\u2010specific behavioural interventions for those who show signs of somatisation, hypervigilance or co\u2010existing disorders of gut\u2010brain interaction. Other low\u2010harm interventions such as lifestyle and dietary advice, should also be better integrated into care at an early stage. Multidisciplinary care management programmes (including dietary, weight loss, exercise and behavioural intervention) should be developed to promote greater self\u2010management and take advantage of the general shift toward the use of remotely accessed health care resources.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Management of reflux\u2010like symptoms should be adapted to reflect the advances in knowledge about the multifactorial aetiology of these symptoms, addressing both acid\u2010related and behavioural components early in management. The time has come to treat the patient, not the \u201cdisease\u201d.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.16930","type":"journal-article","created":{"date-parts":[[2022,4,23]],"date-time":"2022-04-23T04:33:30Z","timestamp":1650688410000},"page":"1492-1500","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Review article: rethinking the \u201cladder\u201d approach to reflux\u2010like symptom management in the era of <scp>PPI<\/scp> \u201cresistance\u201d \u2010 a multidisciplinary perspective"],"prefix":"10.1111","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7275-8927","authenticated-orcid":false,"given":"A. 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