2020 Seoul Consensus on the Diagnosis and Management of Gastroesophageal Reflux Disease
Gastroesophageal reflux disease (GERD) is a condition in which gastric contents regurgitate into the esophagus or beyond, resulting in either troublesome symptoms or complications. GERD is heterogeneous in terms of varied manifestations, test findings, and treatment responsiveness. GERD diagnosis can be established with symptomatology, pathology, or physiology. Recently the Lyon consensus defined the "proven GERD" with concrete evidence for reflux, including advanced grade erosive esophagitis (Los Angeles classification grades C and or D esophagitis), long-segment Barrett's mucosa or peptic strictures on endoscopy or distal esophageal acid exposure time > 6% on 24-hour ambulatory pH-impedance monitoring. However, some Asian researchers have different opinions on whether the same standards should be applied to the Asian population. The prevalence of GERD is increasing in Asia. The present evidence-based guidelines were developed using a systematic review and meta-analysis approach. In GERD with typical symptoms, a proton pump inhibitor test can be recommended as a sensitive, cost-effective, and practical test for GERD diagnosis. Based on a meta-analysis of 19 estimated acid-exposure time values in Asians, the reference range upper limit for esophageal acid exposure time was 3.2% (95% confidence interval, 2.7-3.9%) in the Asian countries. Esophageal manometry and novel impedance measurements, including mucosal impedance and a post-reflux swallow-induced peristaltic wave, are promising in discrimination of GERD among different reflux phenotypes, thus increasing its diagnostic yield. We also propose a long-term strategy of evidence-based GERD treatment with proton pump inhibitors and other drugs.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:27 |
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| Enthalten in: |
Journal of neurogastroenterology and motility - 27(2021), 4 vom: 30. Okt., Seite 453-481 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Jung, Hye-Kyung [VerfasserIn] |
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| Links: |
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| Themen: |
Diagnosis |
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| Anmerkungen: |
Date Revised 31.10.2021 published: Print Citation Status PubMed-not-MEDLINE |
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| doi: |
10.5056/jnm21077 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM331830701 |
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| 500 | |a Date Revised 31.10.2021 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a Gastroesophageal reflux disease (GERD) is a condition in which gastric contents regurgitate into the esophagus or beyond, resulting in either troublesome symptoms or complications. GERD is heterogeneous in terms of varied manifestations, test findings, and treatment responsiveness. GERD diagnosis can be established with symptomatology, pathology, or physiology. Recently the Lyon consensus defined the "proven GERD" with concrete evidence for reflux, including advanced grade erosive esophagitis (Los Angeles classification grades C and or D esophagitis), long-segment Barrett's mucosa or peptic strictures on endoscopy or distal esophageal acid exposure time > 6% on 24-hour ambulatory pH-impedance monitoring. However, some Asian researchers have different opinions on whether the same standards should be applied to the Asian population. The prevalence of GERD is increasing in Asia. The present evidence-based guidelines were developed using a systematic review and meta-analysis approach. In GERD with typical symptoms, a proton pump inhibitor test can be recommended as a sensitive, cost-effective, and practical test for GERD diagnosis. Based on a meta-analysis of 19 estimated acid-exposure time values in Asians, the reference range upper limit for esophageal acid exposure time was 3.2% (95% confidence interval, 2.7-3.9%) in the Asian countries. Esophageal manometry and novel impedance measurements, including mucosal impedance and a post-reflux swallow-induced peristaltic wave, are promising in discrimination of GERD among different reflux phenotypes, thus increasing its diagnostic yield. We also propose a long-term strategy of evidence-based GERD treatment with proton pump inhibitors and other drugs | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a Diagnosis | |
| 650 | 4 | |a Gastroesophageal reflux disease | |
| 650 | 4 | |a Guideline | |
| 650 | 4 | |a Meta-analysis | |
| 650 | 4 | |a Treatment | |
| 700 | 1 | |a Tae, Chung Hyun |e verfasserin |4 aut | |
| 700 | 1 | |a Song, Kyung Ho |e verfasserin |4 aut | |
| 700 | 1 | |a Kang, Seung Joo |e verfasserin |4 aut | |
| 700 | 1 | |a Park, Jong Kyu |e verfasserin |4 aut | |
| 700 | 1 | |a Gong, Eun Jeong |e verfasserin |4 aut | |
| 700 | 1 | |a Shin, Jeong Eun |e verfasserin |4 aut | |
| 700 | 1 | |a Lim, Hyun Chul |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Sang Kil |e verfasserin |4 aut | |
| 700 | 1 | |a Jung, Da Hyun |e verfasserin |4 aut | |
| 700 | 1 | |a Choi, Yoon Jin |e verfasserin |4 aut | |
| 700 | 1 | |a Seo, Seung In |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Joon Sung |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Jung Min |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Beom Jin |e verfasserin |4 aut | |
| 700 | 1 | |a Kang, Sun Hyung |e verfasserin |4 aut | |
| 700 | 1 | |a Park, Chan Hyuk |e verfasserin |4 aut | |
| 700 | 1 | |a Choi, Suck Chei |e verfasserin |4 aut | |
| 700 | 1 | |a Kwon, Joong Goo |e verfasserin |4 aut | |
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| 700 | 1 | |a Park, Moo In |e verfasserin |4 aut | |
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| 700 | 1 | |a Cho, Young Sin |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Han Hong |e verfasserin |4 aut | |
| 700 | 1 | |a Jung, Kee Wook |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Do Hoon |e verfasserin |4 aut | |
| 700 | 1 | |a Moon, Hee Seok |e verfasserin |4 aut | |
| 700 | 1 | |a Miwa, Hirota |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Chien-Lin |e verfasserin |4 aut | |
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| 700 | 1 | |a Wu, Justin C Y |e verfasserin |4 aut | |
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