Canadian Consensus Conference on the Management of Gastroesophageal Reflux Disease in Adults – Update 2004

Abstract

Prospective studies are needed to investigate clinically relevant risk factors for the development of GERD and its complications; GERD progression, on and off therapy; optimal management strategies for typical GERD symptoms in primary care patients; and optimal management strategies for atypical GERD symptoms, Barrett's epithelium and esophageal adenocarcinoma.

Access to Specialist Gastroenterology Care in Canada: Comparison of Wait Times and Consensus Targets

“…Given that the time from enrolment in medical school to completion of subspecialty training in gastroenterology is at least 10 years, human resource shortages will probably constitute a barrier to any significant reductions in wait times for digestive health care. Indeed, the anticipated increase in demand for colonoscopy for colon cancer screening is likely to lengthen wait times still further; limited access to digestive disease consultations and investigations may lead to an increase in alternative, less appropriate investigations (21)(22)(23), with the potential for diminished diagnostic accuracy, suboptimal patient care and increased costs. Alternative care models involving primary care physician endoscopists, nurse practitioners, physician extenders such as nurse endoscopists (24) and gastroenterology physician assistants may shorten wait times for consultation and procedures, but these solutions will also require time to implement and they will not provide a substitute for specialist gastroenterologists.…”

International Consensus on Periprosthetic Joint Infection: Description of the Consensus Process

“…compels the medical community to seek alternatives for development of best practices. A consensus panel is one such alternative, and the process sought to produce a set of procedures and methods using group judgment on a subject matter for which objective information is lacking [2,3,6,11,15,17,20]. When judgments differ, it is important to understand why, and to develop a process to create, if possible, a common view.…”

Clinical Case Report of PPI-refractory Gastro-Esophageal Reflux Disease (GERD) with Korean Medicine Treatment - A Focus on Evaluation of the Abdominal Examination

“…GER disease (GERD) is caused by the reflux of gastric contents into the esophagus and may or may not induce esophageal injury, although the original definition (in the pre-PPI era) usually meant erosive esophagitis (10,11). The mechanisms underlying GERD remain debatable (12); however, transient lower esophageal sphincter relaxation (TLESR), hypotensive lower esophageal sphincter (LES) and retrograde movement of gastric or duodenal contents into the esophagus are the accepted major pathologies in GERD (13).…”