Publication:
Asia-Pacific consensus on the management of gastro-oesophageal reflux disease: An update focusing on refractory reflux disease and Barrett's oesophagus

Issued Date

2016-09-01

Resource Type

Article

ISSN

14683288
00175749

DOI

10.1136/gutjnl-2016-311715

Other identifier(s)

2-s2.0-84973304470

Rights

Mahidol University

Rights Holder(s)

SCOPUS

Bibliographic Citation

Gut. Vol.65, No.9 (2016), 1402-1415

Suggested Citation

Kwong Ming Fock, Nicholas Talley, Khean Lee Goh, Kentaro Sugano, Peter Katelaris, Gerald Holtmann, John E. Pandolfino, Prateek Sharma, Tiing Leong Ang, Michio Hongo, Justin Wu, Minhu Chen, Myung Gyu Choi, Ngai Moh Law, Bor Shyang Sheu, Jun Zhang, Khek Yu Ho, Jose Sollano, Abdul Aziz Rani, Chomsri Kositchaiwat, Shobna Bhatia Asia-Pacific consensus on the management of gastro-oesophageal reflux disease: An update focusing on refractory reflux disease and Barrett's oesophagus. Gut. Vol.65, No.9 (2016), 1402-1415. doi:10.1136/gutjnl-2016-311715 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/41220

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Title

Asia-Pacific consensus on the management of gastro-oesophageal reflux disease: An update focusing on refractory reflux disease and Barrett's oesophagus

Author(s)

Kwong Ming Fock
 Nicholas Talley
 Khean Lee Goh
 Kentaro Sugano
 Peter Katelaris
 Gerald Holtmann
 John E. Pandolfino
 Prateek Sharma
 Tiing Leong Ang
 Michio Hongo
 Justin Wu
 Minhu Chen
 Myung Gyu Choi
 Ngai Moh Law
 Bor Shyang Sheu
 Jun Zhang
 Khek Yu Ho
 Jose Sollano
 Abdul Aziz Rani
 Chomsri Kositchaiwat
 Shobna Bhatia

Other Contributor(s)

Changi General Hospital
 University of Newcastle, Australia
 University of Malaya
 Jichi Medical University
 The University of Sydney
 University of Queensland
 Northwestern University Feinberg School of Medicine
 University of Kansas
 Tohoku University
 Chinese University of Hong Kong
 Sun Yat-Sen University
 The Catholic University of Korea
 National Cheng Kung University Hospital
 Xi'an Jiaotong University
 National University Hospital, Singapore
 University of Sano Tomas
 Universitas Indonesia
 Mahidol University
 King Edward Memorial Hospital India

Abstract

© 2016 Published by the BMJ Publishing Group Limited. Objective Since the publication of the Asia-Pacific consensus on gastro-oesophageal reflux disease in 2008, there has been further scientific advancement in this field. This updated consensus focuses on proton pump inhibitor-refractory reflux disease and Barrett's oesophagus. Methods A steering committee identified three areas to address: (1) burden of disease and diagnosis of reflux disease; (2) proton pump inhibitor-refractory reflux disease; (3) Barrett's oesophagus. Three working groups formulated draft statements with supporting evidence. Discussions were done via email before a final face-to-face discussion. We used a Delphi consensus process, with a 70% agreement threshold, using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria to categorise the quality of evidence and strength of recommendations. Results A total of 32 statements were proposed and 31 were accepted by consensus. A rise in the prevalence rates of gastro-oesophageal reflux disease in Asia was noted, with the majority being non-erosive reflux disease. Overweight and obesity contributed to the rise. Proton pump inhibitor-refractory reflux disease was recognised to be common. A distinction was made between refractory symptoms and refractory reflux disease, with clarification of the roles of endoscopy and functional testing summarised in two algorithms. The definition of Barrett's oesophagus was revised such that a minimum length of 1 cm was required and the presence of intestinal metaplasia no longer necessary. We recommended the use of standardised endoscopic reporting and advocated endoscopic therapy for confirmed dysplasia and early cancer. Conclusions These guidelines standardise the management of patients with refractory gastro-oesophageal reflux disease and Barrett's oesophagus in the Asia-Pacific region.

Keyword(s)

Medicine

Availability

URI

https://repository.li.mahidol.ac.th/handle/20.500.14594/41220

Collections

Scopus 2016-2017