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

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 KositchaiwatShobna Bhatia

研究成果: Article

46 引文 (Scopus)

摘要

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.

原文English
頁(從 - 到)1402-1415
頁數14
期刊Gut
65
發行號9
DOIs
出版狀態Published - 2016 九月 1

指紋

Esophageal Diseases
Barrett Esophagus
Gastroesophageal Reflux
Proton Pump Inhibitors
Metaplasia
Endoscopy
Publications
Obesity
Guidelines

All Science Journal Classification (ASJC) codes

  • Gastroenterology

引用此文

Fock, Kwong Ming ; Talley, Nicholas ; Goh, Khean Lee ; Sugano, Kentaro ; Katelaris, Peter ; Holtmann, Gerald ; Pandolfino, John E. ; Sharma, Prateek ; Ang, Tiing Leong ; Hongo, Michio ; Wu, Justin ; Chen, Minhu ; Choi, Myung Gyu ; Law, Ngai Moh ; Sheu, Bor Shyang ; Zhang, Jun ; Ho, Khek Yu ; Sollano, Jose ; Rani, Abdul Aziz ; Kositchaiwat, Chomsri ; Bhatia, Shobna. / Asia-Pacific consensus on the management of gastro-oesophageal reflux disease : An update focusing on refractory reflux disease and Barrett's oesophagus. 於: Gut. 2016 ; 卷 65, 編號 9. 頁 1402-1415.
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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",
abstract = "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.",
author = "Fock, {Kwong Ming} and Nicholas Talley and Goh, {Khean Lee} and Kentaro Sugano and Peter Katelaris and Gerald Holtmann and Pandolfino, {John E.} and Prateek Sharma and Ang, {Tiing Leong} and Michio Hongo and Justin Wu and Minhu Chen and Choi, {Myung Gyu} and Law, {Ngai Moh} and Sheu, {Bor Shyang} and Jun Zhang and Ho, {Khek Yu} and Jose Sollano and Rani, {Abdul Aziz} and Chomsri Kositchaiwat and Shobna Bhatia",
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Fock, KM, Talley, N, Goh, KL, Sugano, K, Katelaris, P, Holtmann, G, Pandolfino, JE, Sharma, P, Ang, TL, Hongo, M, Wu, J, Chen, M, Choi, MG, Law, NM, Sheu, BS, Zhang, J, Ho, KY, Sollano, J, Rani, AA, Kositchaiwat, C & Bhatia, S 2016, 'Asia-Pacific consensus on the management of gastro-oesophageal reflux disease: An update focusing on refractory reflux disease and Barrett's oesophagus', Gut, 卷 65, 編號 9, 頁 1402-1415. https://doi.org/10.1136/gutjnl-2016-311715

Asia-Pacific consensus on the management of gastro-oesophageal reflux disease : An update focusing on refractory reflux disease and Barrett's oesophagus. / Fock, Kwong Ming; Talley, Nicholas; Goh, Khean Lee; Sugano, Kentaro; Katelaris, Peter; Holtmann, Gerald; Pandolfino, John E.; Sharma, Prateek; Ang, Tiing Leong; Hongo, Michio; Wu, Justin; Chen, Minhu; Choi, Myung Gyu; Law, Ngai Moh; Sheu, Bor Shyang; Zhang, Jun; Ho, Khek Yu; Sollano, Jose; Rani, Abdul Aziz; Kositchaiwat, Chomsri; Bhatia, Shobna.

於: Gut, 卷 65, 編號 9, 01.09.2016, p. 1402-1415.

研究成果: Article

TY - JOUR

T1 - Asia-Pacific consensus on the management of gastro-oesophageal reflux disease

T2 - An update focusing on refractory reflux disease and Barrett's oesophagus

AU - Fock, Kwong Ming

AU - Talley, Nicholas

AU - Goh, Khean Lee

AU - Sugano, Kentaro

AU - Katelaris, Peter

AU - Holtmann, Gerald

AU - Pandolfino, John E.

AU - Sharma, Prateek

AU - Ang, Tiing Leong

AU - Hongo, Michio

AU - Wu, Justin

AU - Chen, Minhu

AU - Choi, Myung Gyu

AU - Law, Ngai Moh

AU - Sheu, Bor Shyang

AU - Zhang, Jun

AU - Ho, Khek Yu

AU - Sollano, Jose

AU - Rani, Abdul Aziz

AU - Kositchaiwat, Chomsri

AU - Bhatia, Shobna

PY - 2016/9/1

Y1 - 2016/9/1

N2 - 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.

AB - 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.

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