Indian consensus on gastroesophageal reflux disease in adults: A position statement of the Indian Society of Gastroenterology.

• 发表时间: 10 2019
• 来源期刊: Indian J Gastroenterol
• DOI: 10.1007/s12664-019-00979-y
• PMID: 31802441
• 文章类型: Journal Article
• 作者列表: Bhatia SJ,Makharia GK,Abraham P,Bhat N,Kumar A,Reddy DN,Ghoshal UC,Ahuja V,Rao GV,Devadas K,Dutta AK,Jain A,Kedia S,Dama R,Kalapala R,Alvares JF,Dadhich S,Dixit VK,Goenka MK,Goswami BD,Issar SK,Leelakrishnan V,Mallath MK,Mathew P,Mathew P,Nandwani S,Pai CG,Peter L,Prasad AVS,Singh D,Sodhi JS,Sud R,Venkataraman J,Midha V,Bapaye A,Dutta U,Jain AK,Kochhar R,Puri AS,Singh SP,Shimpi L,Sood A,Wadhwa RT

关键词: Barrett’s esophagus; Esophageal manometry; Esophageal pH monitoring; Proton pump inhibitors

Mesh: Adult; Antacids / therapeutic use; Consensus; Diet / adverse effects; Esophagitis / epidemiology etiology; Female; Gastroenterology / standards; Gastroesophageal Reflux / epidemiology etiology therapy; Helicobacter Infections / complications; Helicobacter pylori; Histamine H2 Antagonists / therapeutic use; Humans; India / epidemiology; Male; Practice Guidelines as Topic; Prevalence; Proton Pump Inhibitors / therapeutic use; Societies, Medical

Abstract

The Indian Society of Gastroenterology developed this evidence-based practice guideline for management of gastroesophageal reflux disease (GERD) in adults. A modified Delphi process was used to develop this consensus containing 58 statements, which were generated by electronic voting iteration as well as face-to-face meeting and review of the supporting literature primarily from India. These statements include 10 on epidemiology, 8 on clinical presentation, 10 on investigations, 23 on treatment (including medical, endoscopic, and surgical modalities), and 7 on complications of GERD. When the proportion of those who voted either to accept completely or with minor reservation was 80% or higher, the statement was regarded as accepted. The prevalence of GERD in India ranges from 7.6% to 30%, being  < 10% in most population studies, and higher in cohort studies. The dietary factors associated with GERD include use of spices and non-vegetarian food. Helicobacter pylori is thought to have a negative relation with GERD; H. pylori negative patients have higher grade of symptoms of GERD and esophagitis. Less than 10% of GERD patients in India have erosive esophagitis. In patients with occasional or mild symptoms, antacids and histamine H2 receptor blockers (H2RAs) may be used, and proton pump inhibitors (PPI) should be used in patients with frequent or severe symptoms. Prokinetics have limited proven role in management of GERD.