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学科主题: 临床医学
题名:
Asia-Pacific consensus on the management of gastroesophageal reflux disease: Update
作者: Fock, Kwong Ming1; Talley, Nicholas J.2; Fass, Ronnie3; Goh, Khean Lee4; Katelaris, Peter5; Hunt, Richard6; Hongo, Michio7; Ang, Tling Leong1; Holtmann, Gerald8; Nandurkar, Sanjay9; Lin, San Ren10; Wong, Benjamin C. Y.11; Chan, Francis K. L.12; Rani, Abdul Aziz13; Bak, Young-Tae14; Sollano, Jose15; Ho, Lawrence K. Y.16; Manatsathit, Sathoporn17
关键词: consensus ; erosive esophagitis ; non-erosive reflux disease
刊名: JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
发表日期: 2008
DOI: 10.1111/j.1440-1746.2007.05249.x
卷: 23, 期:1, 页:8-22
收录类别: SCI
文章类型: Review
WOS标题词: Science & Technology
类目[WOS]: Gastroenterology & Hepatology
研究领域[WOS]: Gastroenterology & Hepatology
关键词[WOS]: PROTON-PUMP INHIBITORS ; HELICOBACTER-PYLORI INFECTION ; RANDOMIZED CONTROLLED-TRIAL ; ON-DEMAND-THERAPY ; PROSPECTIVE FOLLOW-UP ; LONG-TERM MANAGEMENT ; LOW-DOSE RANITIDINE ; ESOPHAGEAL SPHINCTER FUNCTION ; CHRONIC POSTERIOR LARYNGITIS ; OBSTRUCTIVE SLEEP-APNEA
英文摘要:

Background and Aims: Since the publication of the Asia-Pacific GERD consensus in 2004, more data concerning the epidemiology and management of gastroesophageal reflux disease (GERD) have emerged. An evidence based review and update was needed.

Methods: A multidisciplinary group developed consensus statements using the Delphi approach. Relevant data were presented, and the quality of evidence, strength of recommendation, and level of consensus were graded.

Results: GERD is increasing in frequency in Asia. Risk factors include older age, male sex, race, family history, higher socioeconomic status, increased body mass index, and smoking. Symptomatic response to a proton pump inhibitor (PPI) test is diagnostic in patients with typical symptoms if alarm symptoms are absent. A negative pH study off therapy excludes GERD if a PPI test fails. The role for narrow band imaging, capsule endoscopy, and wireless pH monitoring has not yet been undefined. Diagnostic strategies in Asia must consider coexistent gastric cancer and peptic ulcer. Weight loss and elevation of head of bed improve reflux symptoms. PPIs are the most effective medical treatment. On-demand therapy is appropriate for nonerosive reflux disease (NERD) patients. Patients with chronic cough, laryngitis, and typical GERD symptoms should be offered twice daily PPI therapy after excluding non-GERD etiologies. Fundoplication could be offered to GERD patients when an experienced surgeon is available. Endoscopic treatment of GERD should not be offered outside clinical trials.

Conclusions: Further studies are needed to clarify the role of newer diagnostic modalities and endoscopic therapy. Diagnostic strategies for GERD in Asia must consider coexistent gastric cancer and peptic ulcer. PPIs remain the cornerstone of therapy.

语种: 英语
WOS记录号: WOS:000251671000005
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/63750
Appears in Collections:北京大学第三临床医学院_期刊论文

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作者单位: 1.McMaster Univ, Med Ctr, Hamilton, ON L8S 4L8, Canada
2.Tohoku Univ Hosp, Sendai, Miyagi, Japan
3.Royal Adelaide Hosp, Adelaide, SA 5000, Australia
4.Monash Univ, Melbourne, Vic 3004, Australia
5.Peking Univ, Hosp 3, Beijing 100871, Peoples R China
6.Queen Mary Hosp, Hong Kong, Hong Kong, Peoples R China
7.Univ Indonesia, Jakarta, Indonesia
8.Korea Univ, Coll Med, Seoul 136701, South Korea
9.Univ Santo Tomas, Manila, Philippines
10.Natl Univ Singapore Hosp, Singapore 117548, Singapore
11.Siriraj Hosp, Bangkok, Thailand
12.Univ Malaya, Kuala Lumpur 59100, Malaysia
13.Univ Sydney, Sydney, NSW 2006, Australia
14.Changi Gen Hosp, Dept Med, Div Gastroenterol, Singapore 529889, Singapore
15.Mayo Clin, Coll Med, Rochester, NY USA
16.Univ Arizona, Hlth Sci Ctr, Tucson, AZ USA
17.Prince Wales Hosp, Hong Kong, Hong Kong, Peoples R China

Recommended Citation:
Fock, Kwong Ming,Talley, Nicholas J.,Fass, Ronnie,et al. Asia-Pacific consensus on the management of gastroesophageal reflux disease: Update[J]. JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY,2008,23(1):8-22.
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