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

Khean Lee Goh, Yeong Yeh Lee, Somchai Leelakusolvong, Dadang Makmun, Monthira Maneerattanaporn, Duc Trong Quach, Raja Affendi Raja Ali, Jose D. Sollano, Van Huy Tran, Reuben Kong Min Wong

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)855-863
Number of pages9
JournalJGH Open
Volume5
Issue number8
DOIs
Publication statusPublished - Aug 2021

Keywords

  • alginates
  • consensus recommendations
  • mild-to-moderate gastroesophageal reflux disease
  • proton-pump inhibitors

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