Dear Doctor, Latest ISG guidelines published in Oct 2023 on optimizing the use of PPIs recommend double dose PPIs in severe erosive esophagitis & peptic strictures. Razo 40, the double strength Rabeprazole provides powerful acid suppression as it maintains pH greater than 4 for more than 17 hours and helps healing of Ulcers. Start with Razo 40 in all Severe GERD cases and continue with a maintenance therapy of Razo 20