| Title | Asia-Pacific consensus on the management of gastroesophageal reflux disease: Update |
| Authors | Fock, Kwong Ming Talley, Nicholas J. Fass, Ronnie Goh, Khean Lee Katelaris, Peter Hunt, Richard Hongo, Michio Ang, Tling Leong Holtmann, Gerald Nandurkar, Sanjay Lin, San Ren Wong, Benjamin C. Y. Chan, Francis K. L. Rani, Abdul Aziz Bak, Young-Tae Sollano, Jose Ho, Lawrence K. Y. Manatsathit, Sathoporn |
| Affiliation | Changi Gen Hosp, Dept Med, Div Gastroenterol, Singapore 529889, Singapore. Mayo Clin, Coll Med, Rochester, NY USA. Univ Arizona, Hlth Sci Ctr, Tucson, AZ USA. Univ Malaya, Kuala Lumpur 59100, Malaysia. Univ Sydney, Sydney, NSW 2006, Australia. McMaster Univ, Med Ctr, Hamilton, ON L8S 4L8, Canada. Tohoku Univ Hosp, Sendai, Miyagi, Japan. Royal Adelaide Hosp, Adelaide, SA 5000, Australia. Monash Univ, Melbourne, Vic 3004, Australia. Peking Univ, Hosp 3, Beijing 100871, Peoples R China. Queen Mary Hosp, Hong Kong, Hong Kong, Peoples R China. Prince Wales Hosp, Hong Kong, Hong Kong, Peoples R China. Univ Indonesia, Jakarta, Indonesia. Korea Univ, Coll Med, Seoul 136701, South Korea. Univ Santo Tomas, Manila, Philippines. Natl Univ Singapore Hosp, Singapore 117548, Singapore. Siriraj Hosp, Bangkok, Thailand. Changi Gen Hosp, Dept Med, Div Gastroenterol, 2 Simei St 3, Singapore 529889, Singapore. |
| Keywords | consensus erosive esophagitis non-erosive reflux disease PROTON-PUMP INHIBITORS HELICOBACTER-PYLORI INFECTION RANDOMIZED CONTROLLED-TRIAL ON-DEMAND-THERAPY PROSPECTIVE FOLLOW-UP LONG-TERM MANAGEMENT LOW-DOSE RANITIDINE ESOPHAGEAL SPHINCTER FUNCTION CHRONIC POSTERIOR LARYNGITIS OBSTRUCTIVE SLEEP-APNEA |
| Issue Date | 2008 |
| Publisher | journal of gastroenterology and hepatology |
| Citation | JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY.2008,23,(1),8-22. |
| 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. |
| URI | http://hdl.handle.net/20.500.11897/249427 |
| ISSN | 0815-9319 |
| DOI | 10.1111/j.1440-1746.2007.05249.x |
| Indexed | SCI(E) |
| Appears in Collections: | 第三医院 |
