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New guidelines for managing adults
suffering from gastroesophageal reflux disease (GERD) have been released by
Association of Physicians of India-Indian Society of Gastroenterology
(API-ISG).
The evidence-based guidelines for managing patients with GERD, a common problem in the community, have been released by API-ISG. Using a modified Delphi process, this consensus containing 43 statements was developed. It was produced by face-to-face meetings, electronic voting iteration, and analysis of the assisting literature majorly from India.
Notably, these statements incorporated nine on clinical presentation, one on GERD complications, 11 on investigations, four on epidemiology, and about 18 on treatment (endoscopic, medical, and surgical modalities). The statements were considered as approved when the percentage of those who voted either to completely agree or having minor reservation was about 80% or more.
In India, the GERD occurrence in large population-based studies is approximately 10%. This is probably rising due to lifestyle modifications and elevation in obesity. In the community, the GERD diagnosis should be primarily based on the presence of classical symptoms like sour regurgitation and heartburn. Empiric management with a proton pump inhibitor (PPI) agent or H2 receptor antagonist should be administered.
In the alleviation of symptoms, all the PPI agents in equipotent doses are comparable in their efficacy. Those individuals in which the symptoms do not suitably respond to PPI therapy are considered as suffering from PPI refractory GERD. In individuals having alarm symptoms and those having refractory GERD, the invasive assessments should be limited.
The Journal of the Association of Physicians of India.
API-ISG Consensus Guidelines for Management of Gastrooesophageal Reflux Disease
Shobna Bhatia et al.
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