ACG Clinical Guideline for the Diagnosis and Management of Gastroesophageal Reflux Disease

Gastroesophageal reflux disease (GERD) continues to be among the most common diseases seen by gastroenterologists, surgeons, and primary care physicians. Our understanding of the varied presentations of GERD, enhancements in diagnostic testing, and approach to patient management have evolved. During...

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Veröffentlicht in:The American journal of gastroenterology Jg. 117; H. 1; S. 27 - 56
Hauptverfasser: Katz, Philip O., Dunbar, Kerry B., Schnoll-Sussman, Felice H., Greer, Katarina B., Yadlapati, Rena, Spechler, Stuart Jon
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States Wolters Kluwer 01.01.2022
Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins
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ISSN:0002-9270, 1572-0241, 1572-0241
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Abstract Gastroesophageal reflux disease (GERD) continues to be among the most common diseases seen by gastroenterologists, surgeons, and primary care physicians. Our understanding of the varied presentations of GERD, enhancements in diagnostic testing, and approach to patient management have evolved. During this time, scrutiny of proton pump inhibitors (PPIs) has increased considerably. Although PPIs remain the medical treatment of choice for GERD, multiple publications have raised questions about adverse events, raising doubts about the safety of long-term use and increasing concern about overprescribing of PPIs. New data regarding the potential for surgical and endoscopic interventions have emerged. In this new document, we provide updated, evidence-based recommendations and practical guidance for the evaluation and management of GERD, including pharmacologic, lifestyle, surgical, and endoscopic management. The Grading of Recommendations, Assessment, Development, and Evaluation system was used to evaluate the evidence and the strength of recommendations. Key concepts and suggestions that as of this writing do not have sufficient evidence to grade are also provided.
AbstractList Gastroesophageal reflux disease (GERD) continues to be among the most common diseases seen by gastroenterologists, surgeons, and primary care physicians. Our understanding of the varied presentations of GERD, enhancements in diagnostic testing, and approach to patient management have evolved. During this time, scrutiny of proton pump inhibitors (PPIs) has increased considerably. Although PPIs remain the medical treatment of choice for GERD, multiple publications have raised questions about adverse events, raising doubts about the safety of long-term use and increasing concern about overprescribing of PPIs. New data regarding the potential for surgical and endoscopic interventions have emerged. In this new document, we provide updated, evidence-based recommendations and practical guidance for the evaluation and management of GERD, including pharmacologic, lifestyle, surgical, and endoscopic management. The Grading of Recommendations, Assessment, Development, and Evaluation system was used to evaluate the evidence and the strength of recommendations. Key concepts and suggestions that as of this writing do not have sufficient evidence to grade are also provided.
Gastroesophageal reflux disease (GERD) continues to be among the most common diseases seen by gastroenterologists, surgeons, and primary care physicians. Our understanding of the varied presentations of GERD, enhancements in diagnostic testing, and approach to patient management have evolved. During this time, scrutiny of proton pump inhibitors (PPIs) has increased considerably. Although PPIs remain the medical treatment of choice for GERD, multiple publications have raised questions about adverse events, raising doubts about the safety of long-term use and increasing concern about overprescribing of PPIs. New data regarding the potential for surgical and endoscopic interventions have emerged. In this new document, we provide updated, evidence-based recommendations and practical guidance for the evaluation and management of GERD, including pharmacologic, lifestyle, surgical, and endoscopic management. The Grading of Recommendations, Assessment, Development, and Evaluation system was used to evaluate the evidence and the strength of recommendations. Key concepts and suggestions that as of this writing do not have sufficient evidence to grade are also provided.Gastroesophageal reflux disease (GERD) continues to be among the most common diseases seen by gastroenterologists, surgeons, and primary care physicians. Our understanding of the varied presentations of GERD, enhancements in diagnostic testing, and approach to patient management have evolved. During this time, scrutiny of proton pump inhibitors (PPIs) has increased considerably. Although PPIs remain the medical treatment of choice for GERD, multiple publications have raised questions about adverse events, raising doubts about the safety of long-term use and increasing concern about overprescribing of PPIs. New data regarding the potential for surgical and endoscopic interventions have emerged. In this new document, we provide updated, evidence-based recommendations and practical guidance for the evaluation and management of GERD, including pharmacologic, lifestyle, surgical, and endoscopic management. The Grading of Recommendations, Assessment, Development, and Evaluation system was used to evaluate the evidence and the strength of recommendations. Key concepts and suggestions that as of this writing do not have sufficient evidence to grade are also provided.
Author Greer, Katarina B.
Spechler, Stuart Jon
Katz, Philip O.
Dunbar, Kerry B.
Schnoll-Sussman, Felice H.
Yadlapati, Rena
AuthorAffiliation Division of Gastroenterology, Department of Medicine, University of California SanDiego, La Jolla, California, USA
Department of Medicine, Case Western Reserve University School of Medicine, Cleveland Louis Stokes VA Medical Center, Cleveland, Ohio, USA
Department of Medicine, Division of Gastroenterology and Hepatology, Jay Monahan Center for Gastrointestinal Health, Weill Cornell Medicine, New York, New York, USA
AuthorAffiliation_xml – name: Division of Gastroenterology, Department of Medicine, University of California SanDiego, La Jolla, California, USA
– name: Department of Medicine, Division of Gastroenterology and Hepatology, Jay Monahan Center for Gastrointestinal Health, Weill Cornell Medicine, New York, New York, USA
– name: Department of Medicine, Case Western Reserve University School of Medicine, Cleveland Louis Stokes VA Medical Center, Cleveland, Ohio, USA
Author_xml – sequence: 1
  givenname: Philip O.
  surname: Katz
  fullname: Katz, Philip O.
  organization: Department of Medicine, Division of Gastroenterology and Hepatology, Jay Monahan Center for Gastrointestinal Health, Weill Cornell Medicine, New York, New York, USA
– sequence: 2
  givenname: Kerry B.
  surname: Dunbar
  fullname: Dunbar, Kerry B.
  organization: Department of Medicine, University of Texas Southwestern Medical Center, Dallas VA Medical Center, Dallas, Texas, USA
– sequence: 3
  givenname: Felice H.
  surname: Schnoll-Sussman
  fullname: Schnoll-Sussman, Felice H.
  organization: Department of Medicine, Division of Gastroenterology and Hepatology, Jay Monahan Center for Gastrointestinal Health, Weill Cornell Medicine, New York, New York, USA
– sequence: 4
  givenname: Katarina B.
  surname: Greer
  fullname: Greer, Katarina B.
  organization: Department of Medicine, Case Western Reserve University School of Medicine, Cleveland Louis Stokes VA Medical Center, Cleveland, Ohio, USA
– sequence: 5
  givenname: Rena
  surname: Yadlapati
  fullname: Yadlapati, Rena
  organization: Division of Gastroenterology, Department of Medicine, University of California SanDiego, La Jolla, California, USA
– sequence: 6
  givenname: Stuart Jon
  surname: Spechler
  fullname: Spechler, Stuart Jon
  organization: Division of Gastroenterology, Baylor University Medical Center at Dallas, Dallas, Texas, USA
BackLink https://www.ncbi.nlm.nih.gov/pubmed/34807007$$D View this record in MEDLINE/PubMed
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Cheungpasit
36002917 - Am J Gastroenterol. 2022 Dec 1;117(12):2083
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Snippet Gastroesophageal reflux disease (GERD) continues to be among the most common diseases seen by gastroenterologists, surgeons, and primary care physicians. Our...
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SubjectTerms Asthma
Diagnostic tests
Disease
Disease Management
Endoscopy
Endoscopy, Digestive System - methods
Esophagus
Gastroenterology
Gastroesophageal reflux
Gastroesophageal Reflux - diagnosis
Gastroesophageal Reflux - therapy
Humans
Pain
Pathophysiology
Patients
Proton Pump Inhibitors - therapeutic use
Systematic review
Title ACG Clinical Guideline for the Diagnosis and Management of Gastroesophageal Reflux Disease
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