Abstract：
BACKGROUND: Gastroesophageal Reflux Disease (GERD) is a prevalent condition in Brazil, affecting 12% to 20% of the urban population, with significant implications for patient quality of life and potential for complications.
OBJECTIVE: This paper focuses on the recent update of the Brazilian guidelines for GERD, a necessary revision due to advancements in knowledge and practice since the last publication over a decade ago. The update pays particular attention to the role and safety of proton pump inhibitors (PPIs), acknowledging the growing concerns about their long-term use, adverse events, and overprescription.
METHODS: The methodology of the guideline update involved an extensive literature review in multiple languages (English, French, Italian, Spanish, and Portuguese), drawing from major databases such as Medline, Embase, and SciELO-Lilacs.
RESULTS: This comprehensive approach resulted in a carefully curated selection of studies, systematic reviews, and meta-analyses, specifically focusing on PPIs and other therapeutic strategies for GERD. The updated guidelines are presented in a user-friendly question-and-answer format, adhering to the PICO system (Population, Intervention, Comparison, Outcomes) for clarity and ease of interpretation. The recommendations are supported by robust scientific evidence and expert opinions, enhancing their practical applicability in clinical settings. To ensure the reliability and clarity of the recommendations, the GRADE system (Grading of Recommendations Assessment, Development, and Evaluation) was employed. This system categorizes the strength of recommendations as strong, weak, or conditional and classifies evidence quality as high, moderate, low, or very low. These classifications provide insight into the confidence level of each recommendation and the likelihood of future research impacting these guidelines.
CONCLUSIONS: The primary aim of these updated guidelines is to offer practical, evidence-based advice for the management of GERD in Brazil, ensuring that healthcare professionals are equipped with the latest knowledge and tools to deliver optimal patient care.
BACKGROUND: •Gastrointestinal specialists rely heavily on guidelines to manage digestive pathologies effectively. The Brazilian clinical guideline for therapeutic management of gastroesophageal reflux disease (GERD) is an invaluable tool for these specialists.
BACKGROUND: •It critically analyzes practical aspects of therapy through 12 questions covering a wide range of topics, from behavioral measures to surgical and endoscopic indications.
BACKGROUND: •The recommendations in this guideline are justified using the GRADE system (Grading of Recommendations Assessment, Development, and Evaluation), and experienced experts provide comments and suggestions at the end of each question.
OBJECTIVE: This paper focuses on the recent update of the Brazilian guidelines for GERD, a necessary revision due to advancements in knowledge and practice since the last publication over a decade ago. The update pays particular attention to the role and safety of proton pump inhibitors (PPIs), acknowledging the growing concerns about their long-term use, adverse events, and overprescription.
METHODS: The methodology of the guideline update involved an extensive literature review in multiple languages (English, French, Italian, Spanish, and Portuguese), drawing from major databases such as Medline, Embase, and SciELO-Lilacs.
RESULTS: This comprehensive approach resulted in a carefully curated selection of studies, systematic reviews, and meta-analyses, specifically focusing on PPIs and other therapeutic strategies for GERD. The updated guidelines are presented in a user-friendly question-and-answer format, adhering to the PICO system (Population, Intervention, Comparison, Outcomes) for clarity and ease of interpretation. The recommendations are supported by robust scientific evidence and expert opinions, enhancing their practical applicability in clinical settings. To ensure the reliability and clarity of the recommendations, the GRADE system (Grading of Recommendations Assessment, Development, and Evaluation) was employed. This system categorizes the strength of recommendations as strong, weak, or conditional and classifies evidence quality as high, moderate, low, or very low. These classifications provide insight into the confidence level of each recommendation and the likelihood of future research impacting these guidelines.
CONCLUSIONS: The primary aim of these updated guidelines is to offer practical, evidence-based advice for the management of GERD in Brazil, ensuring that healthcare professionals are equipped with the latest knowledge and tools to deliver optimal patient care.
BACKGROUND: •Gastrointestinal specialists rely heavily on guidelines to manage digestive pathologies effectively. The Brazilian clinical guideline for therapeutic management of gastroesophageal reflux disease (GERD) is an invaluable tool for these specialists.
BACKGROUND: •It critically analyzes practical aspects of therapy through 12 questions covering a wide range of topics, from behavioral measures to surgical and endoscopic indications.
BACKGROUND: •The recommendations in this guideline are justified using the GRADE system (Grading of Recommendations Assessment, Development, and Evaluation), and experienced experts provide comments and suggestions at the end of each question.
摘要：
背景：胃食管反流病（GERD）是巴西的一种常见病，影响了12%到20%的城市人口，对患者的生活质量和潜在的并发症有重大影响。
目的：本文重点介绍巴西GERD指南的最新更新，由于知识和实践的进步，自十年前的最后一次出版以来，这是一个必要的修订。更新特别关注质子泵抑制剂（PPI）的作用和安全性，承认人们越来越担心它们的长期使用，不良事件,和处方过量。
方法：指南更新的方法涉及多种语言的广泛文献综述（英语，法语,意大利语,西班牙语,和葡萄牙语)，从Medline等主要数据库中提取，Embase,还有SciELO-丁香花.
结果：这种全面的方法导致了精心策划的研究选择，系统评价,和荟萃分析，特别关注PPI和其他GERD治疗策略。更新后的准则以用户友好的问答形式呈现，坚持PICO系统(人口，干预,比较,结果)为清晰和易于解释。这些建议得到了强有力的科学证据和专家意见的支持，增强其在临床环境中的实际适用性。为了确保建议的可靠性和清晰度，等级制度(建议评估分级，发展,和评估)被采用。该系统将建议的强度分类为强，弱,或有条件的，并将证据质量分类为高，中度,低,或者非常低。这些分类提供了对每个建议的置信水平以及未来研究影响这些指南的可能性的见解。
结论：这些更新指南的主要目的是提供实用的，为巴西GERD的管理提供基于证据的建议，确保医疗保健专业人员配备最新的知识和工具，以提供最佳的患者护理。
背景：•胃肠道专家严重依赖指南来有效管理消化系统病变。巴西胃食管反流病（GERD）治疗管理的临床指南是这些专家的宝贵工具。
背景：•它通过涵盖广泛主题的12个问题来批判性地分析治疗的实际方面，从行为措施到手术和内窥镜适应症。
背景：•本指南中的建议使用分级系统（建议评估的分级，发展,和评估)，经验丰富的专家在每个问题的末尾提供意见和建议。
目的：本文重点介绍巴西GERD指南的最新更新，由于知识和实践的进步，自十年前的最后一次出版以来，这是一个必要的修订。更新特别关注质子泵抑制剂（PPI）的作用和安全性，承认人们越来越担心它们的长期使用，不良事件,和处方过量。
方法：指南更新的方法涉及多种语言的广泛文献综述（英语，法语,意大利语,西班牙语,和葡萄牙语)，从Medline等主要数据库中提取，Embase,还有SciELO-丁香花.
结果：这种全面的方法导致了精心策划的研究选择，系统评价,和荟萃分析，特别关注PPI和其他GERD治疗策略。更新后的准则以用户友好的问答形式呈现，坚持PICO系统(人口，干预,比较,结果)为清晰和易于解释。这些建议得到了强有力的科学证据和专家意见的支持，增强其在临床环境中的实际适用性。为了确保建议的可靠性和清晰度，等级制度(建议评估分级，发展,和评估)被采用。该系统将建议的强度分类为强，弱,或有条件的，并将证据质量分类为高，中度,低,或者非常低。这些分类提供了对每个建议的置信水平以及未来研究影响这些指南的可能性的见解。
结论：这些更新指南的主要目的是提供实用的，为巴西GERD的管理提供基于证据的建议，确保医疗保健专业人员配备最新的知识和工具，以提供最佳的患者护理。
背景：•胃肠道专家严重依赖指南来有效管理消化系统病变。巴西胃食管反流病（GERD）治疗管理的临床指南是这些专家的宝贵工具。
背景：•它通过涵盖广泛主题的12个问题来批判性地分析治疗的实际方面，从行为措施到手术和内窥镜适应症。
背景：•本指南中的建议使用分级系统（建议评估的分级，发展,和评估)，经验丰富的专家在每个问题的末尾提供意见和建议。
