AGA Clinical Practice Update on the Personalized Approach to the Evaluation and Management of GERD: Expert Review

Yadlapati, Rena; Gyawali, C Prakash; Pandolfino, John E.; Chang, Kenneth J.; Kahrilas, Peter J.; Katz, Philip O.; Katzka, David A.; Komanduri, Sri; Lipham, John C.; Menard‐Katcher, Paul; Muthusamy, V. Raman; Richter, Joel E.; Sharma, Virender K.; Vaezi, Michael F.; Wani, Sachin

doi:10.1016/j.cgh.2022.01.025

Cited by 171 publications

(199 citation statements)

References 55 publications

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“…Nonetheless, as per the Lyon consensus and other recent guidelines, the panel agrees that mean nocturnal baseline impedance and post‐reflux swallow peristaltic wave index are of value, particularly for the inconclusive GERD scenarios 402 . While beyond the scope of this initiative, it is important to note the critical importance of oesophageal physiologic tests such as high‐resolution manometry to exclude achalasia in patients undergoing evaluation for anti‐reflux surgery 1,4,41 …”

Section: Discussionmentioning

confidence: 80%

Clinical role of ambulatory reflux monitoring in PPI non‐responders: recommendation statements

Yadlapati

Gawron

Gyawali

et al. 2022

Aliment Pharmacol Ther

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Background: Optimal ambulatory reflux monitoring methodology in symptomatic reflux patients continues to be debated. Aims: To utilise published literature and expert opinion to develop recommendation statements addressing use of ambulatory reflux monitoring in clinical practice Methods: The RAND Appropriateness Method (RAM) was utilised among 17 experts with discussion, revision and two rounds of ranking of recommendation statements. Ambulatory reflux monitoring protocol, methodology and thresholds ranked as appropriate by ≥80% of panellists met the criteria for appropriateness. Results: Prolonged (96-h recommended) wireless pH monitoring off proton pump inhibitor (PPI) was identified as the appropriate diagnostic tool to assess the need for acid suppression in patients with unproven gastro-oesophageal reflux disease | 1275 YADLAPATI et al.

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Section: Discussionmentioning

confidence: 80%

Clinical role of ambulatory reflux monitoring in PPI non‐responders: recommendation statements

Yadlapati

Gawron

Gyawali

et al. 2022

Aliment Pharmacol Ther

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“…Moreover, it is widely accepted that the mucosal lesions caused by GERD have to be treated with PPI therapy combined with other active substances or devices able to potentiate the effects of the PPI and, thus, improve mucosal defenses [ 8 , 9 ]. These devices improve mucosal defenses by creating a film over the esophageal mucosa and acting as a mechanical barrier against the noxious components of both acidic and basic refluxate [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

The Effect of Hyaluronic Acid and Chondroitin Sulphate-Based Medical Device Combined with Acid Suppression in the Treatment of Atypical Symptoms in Gastroesophageal Reflux Disease

Pellegatta

Mangiavillano

Semeraro

et al. 2022

JCM

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Extraesophageal reflux symptoms are increasingly common in the Western population and their clinical management is still controversial. Although therapy with proton-pump inhibitors (PPIs) represents the gold standard, to date, many patients are refractory to this treatment. The aim of this study was to evaluate, in patients with a recent diagnosis of GERD experiencing extraesophageal symptoms, the efficacy and safety of a 6-week treatment with PPI acid suppression in combination with Gerdoff® (a hyaluronic acid and chondroitin sulphate-based medical device) compared to PPI monotherapy. The trial verified the reduction in symptom frequency and severity by evaluating the proportion of Responders and Non-Responder patients after 6 weeks of treatment, compared to baseline. The effects of Gerdoff® + PPI treatment on extraesophageal symptoms were also evaluated after a 12-week follow up only in Responder patients. The analysis of the change in total Reflux Symptoms Index (RSI) score from baseline to the other time points showed that the extent of the decrease from baseline was higher in the Gerdoff® + PPI group than in the PPI group at any time point. However, the comparison between groups did not show statistically significant differences at any time point. A statistically significant difference, in favor of the Gerdoff® + PPI group, was observed for individual RSI items. Even if the trial showed some limitations, this is the first published study on the efficacy of a medical device containing hyaluronic acid and chondroitin sulphate with antacid in the treatment of extraesophageal reflux symptoms.

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“…Гастроэзофагеальная рефлюксная болезнь (ГЭРБ) является одной из наиболее частых патологий в структуре гастроэнтерологических заболеваний [1]. По данным современного метаанализа, суммарная распространенность еженедельной изжоги в различных регионах мира составляет 13,3% [2].…”

Section: Introductionunclassified

Efficacy of rabeprazole (Razo®) in the treatment of various clinical variants of GERD: results from the GERBERA study

et al. 2022

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Introduction. Gastroesophageal reflux disease (GERD) is extremely common in the structure of gastroenterological diseases. Aim. To conduct a prospective observational post-marketing study of rabeprazole (Razo®) 20 mg taking once daily in patients with non-erosive reflux disease (NERD) after 2 and 4 weeks of therapy and esophagitis stage A and B after 4 weeks of therapy (GERBERA).Materials and methods. 75 patients with GERD were included in the study (36 men and 39 women, mean age 41.7 ± 1.5 years). Clinical examination with the completion of standard questionnaires, assessment of the quality of life of patients were performed at three visits: before the start of the treatment, after 2 and 4 weeks of therapy. Fibroesophagogastroduodenoscopy was performed in all patients before treatment and in patients with esophagitis after 4 weeks of therapy. All patients received rabeprazole (Razo®) at a dose of 20 mg once a day for the treatment of GERD. The diagnosis of heartburn and sour eructation was carried out according to the recommendations of the Montreal Consensus, the diagnosis of esophagitis was performed based on the Los Angeles classification.Results and discussion. Among patients with NERD, 74.1% of patients responded to Razo® therapy after 2 weeks of treatment, after 4 weeks the proportion of responders increased to 94.4% (p = 0.008). Healing of erosions after 4 weeks was observed in 90.5% of patients with esophagitis. Razo® therapy was accompanied by a pronounced improvement in GERD patients in all parameters of quality of life and patient satisfaction with the results of Razo® treatment.Conclusion. Based on the results of our study, we obtained high efficacy of Razo® at a dose of 20 mg once a day for the treatment of patients with NERD and erosive esophagitis.

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AGA Clinical Practice Update on the Personalized Approach to the Evaluation and Management of GERD: Expert Review

Cited by 171 publications

References 55 publications

Clinical role of ambulatory reflux monitoring in PPI non‐responders: recommendation statements

Clinical role of ambulatory reflux monitoring in PPI non‐responders: recommendation statements

The Effect of Hyaluronic Acid and Chondroitin Sulphate-Based Medical Device Combined with Acid Suppression in the Treatment of Atypical Symptoms in Gastroesophageal Reflux Disease

Efficacy of rabeprazole (Razo®) in the treatment of various clinical variants of GERD: results from the GERBERA study

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