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Cited 130 time in webofscience Cited 154 time in scopus
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Asia-Pacific consensus on the management of gastroesophageal reflux disease: Update

Authors
Fock, Kwong MingTalley, Nicholas J.Fass, RonnieGoh, Khean LeeKatelaris, PeterHunt, RichardHongo, MichioAng, Tling LeongHoltmann, GeraldNandurkar, SanjayLin, San RenWong, Benjamin C. Y.Chan, Francis K. L.Rani, Abdul AzizBak, Young-TaeSollano, JoseHo, Lawrence K. Y.Manatsathit, Sathoporn
Issue Date
Jan-2008
Publisher
WILEY
Keywords
consensus; erosive esophagitis; non-erosive reflux disease
Citation
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, v.23, no.1, pp.8 - 22
Indexed
SCIE
SCOPUS
Journal Title
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
Volume
23
Number
1
Start Page
8
End Page
22
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/35760
DOI
10.1111/j.1440-1746.2007.05249.x
ISSN
0815-9319
Abstract
Background and Aims: Since the publication of the Asia-Pacific GERD consensus in 2004, more data concerning the epidemiology and management of gastroesophageal reflux disease (GERD) have emerged. An evidence based review and update was needed. Methods: A multidisciplinary group developed consensus statements using the Delphi approach. Relevant data were presented, and the quality of evidence, strength of recommendation, and level of consensus were graded. Results: GERD is increasing in frequency in Asia. Risk factors include older age, male sex, race, family history, higher socioeconomic status, increased body mass index, and smoking. Symptomatic response to a proton pump inhibitor (PPI) test is diagnostic in patients with typical symptoms if alarm symptoms are absent. A negative pH study off therapy excludes GERD if a PPI test fails. The role for narrow band imaging, capsule endoscopy, and wireless pH monitoring has not yet been undefined. Diagnostic strategies in Asia must consider coexistent gastric cancer and peptic ulcer. Weight loss and elevation of head of bed improve reflux symptoms. PPIs are the most effective medical treatment. On-demand therapy is appropriate for nonerosive reflux disease (NERD) patients. Patients with chronic cough, laryngitis, and typical GERD symptoms should be offered twice daily PPI therapy after excluding non-GERD etiologies. Fundoplication could be offered to GERD patients when an experienced surgeon is available. Endoscopic treatment of GERD should not be offered outside clinical trials. Conclusions: Further studies are needed to clarify the role of newer diagnostic modalities and endoscopic therapy. Diagnostic strategies for GERD in Asia must consider coexistent gastric cancer and peptic ulcer. PPIs remain the cornerstone of therapy.
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Bak, Young Tae
Guro Hospital (Department of Gastroenterology and Hepatology, Guro Hospital)
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