Consensus statements and recommendations on the management of mild‐to‐moderate gastroesophageal reflux disease in the Southeast Asian region

Abstract

This paper reports the proceedings from the first consensus meeting on the management of mild‐to‐moderate gastroesophageal reflux disease (GERD) in the Southeast Asian (SEA) region. Seventeen statements were drawn up by a steering committee that focused on epidemiology, mechanism of action, diagnostic investigations, and treatment. Voting on the recommendations used the Delphi method with two rounds of voting among the 10 panel members. The consensus panel agreed that GERD is mostly a mild disease in the SEA region with predominantly non‐erosive reflux disease (NERD). Complicated GERD and Barrett's esophagus are infrequently seen. The panel recommended endoscopy in patients with alarm or refractory symptoms but cautioned that the incidence of gastric cancer is higher in SEA. pH and impedance measurements were not recommended for routine assessment. The acid pocket is recognized as an important pathogenic factor in GERD. Lifestyle measures such as weight reduction, avoidance of smoking, reduction of alcohol intake, and elevation of the head of the bed were recommended but strict avoidance of specific foods or drinks was not. Alginates was recommended as the first‐line treatment for patients with mild‐to‐moderate GERD while recognizing that proton‐pump inhibitors (PPIs) remained the mainstay of treatment of GERD. The use of alginates was also recommended as adjunctive therapy when GERD symptoms were only partially responsive to PPIs.

Gastroesophageal Reflux Disease and Obesity

“…However, the only measures that have been shown to be beneficial on the part of obese patient is weight loss [37]. Weight loss is strongly recommended in overweight or obese GERD patients to improve the reflux symptoms [6,36]. A prospective cohort study has found that in GERD subjects with overweight and obesity, weight reduction was significantly decreased the overall prevalence of GERD with significant improvement in overall symptoms scoring, compared to baseline [38].…”

“…Recent evidence showed a rising prevalence of GERD and it was estimated 1.03 billion individuals are suffering from GERD globally [4,5]. GERD has also become more prevalent nowadays in a previously uncommon region, such as Asia Pacific [6]. Excessive body weight is one of the multiple conditions that contribute to this escalation in GERD cases [7].…”

Феномен Взаємного Обтяження Соvіd-19 Та Гастроезофагеальної Рефлюксної Хвороби З Ларингофарингеальними Проявами

“…За результатами першої консенсусної зустрічі щодо лікування Герх у регіоні Південно-східної азії альгінати рекомендували як препарати 1-ї лінії для пацієнтів із Герх легкого та середнього ступеня тяжкості, а також як допоміжну терапію, коли симптоми Герх лише частково реагували на ІПП [47].…”

The prevalence of coronary atherosclerosis in patients with refractory gastroesophageal reflux disease ready for antireflux surgery

“…The overall prevalence of GERD in adults is 13.3%, with a higher rate of 19.6% in Central America and 22.1% in South Asia. [ 3 ] GERD can result in diminished health-related quality of life, and potential long-term treatment can consume substantial health care resources.…”

“…[ 7 , 8 ] Simultaneously, the global prevalence of GERD has also been reported to be increased. [ 3 , 9 ] CAS and GERD share common risk factors and a common neurological pathway for their corresponding functions, which can make GERD and CAS interact and mutually reinforce each other. [ 10 , 11 ] On the one hand, gastroesophageal acid reflux via the vagal reflex may cause coronary hypoperfusion.…”